Association between maternal selenium levels and pregnancy outcome among human immunodeficiency virus-positive and human immunodeficiency virus-negative pregnant women in a tertiary health-care center in Owerri, Nigeria: A comparative cross-sectional study.

Background: Human immunodeficiency virus (HIV) infection constitutes a major medical complication of pregnancy and is associated with adverse feto-maternal outcomes. However, the relationship between maternal serum selenium levels and pregnancy outcomes has been inconsistent. Objective: This study aimed to determine the relationship between maternal serum selenium status and pregnancy outcome in HIV-positive and HIV-negative women in a tertiary health facility. Methodology: A.comparative cross-sectional study was carried out among HIV-positive and HIV-negative pregnant women at a tertiary health-care facility in Owerri. Participants were recruited from the labor ward and interviewed using a structured questionnaire. One hundred and ten HIV-positive pregnant women were compared with an equal number of HIV-negative pregnant women. They were matched for age, parity and gestational age. Selenium level was measured using atomic absorption spectrophotometer. Maternal packed cell volume (PCV) was also assessed at recruitment. At delivery, the birth weight was measured using a standard weighing scale and documented. Cases of preterm births, perinatal deaths, major congenital abnormalities, and neonatal admission were noted and also documented. Statistical analysis was performed using means and standard deviation. Chi-square test, Student's t-test, logistic regression, and Pearson correlation were also employed. Statistical significance was considered at P < 0.05. Results: HIV-positive pregnant women had significantly lower mean serum selenium concentration compared with HIV-negative pregnant women (64.3 ± 19.6 µg/L vs. 100.1 ± 30.9 µg/L; P < 0.001). There was a statistically significant association between serum selenium concentration and birth weight among both HIV-positive and HIV-negative pregnant women (P < 0.001). Similarly, a statistically significant association was seen between serum selenium and maternal PCV in HIV-positive and HIV-negative pregnant women (P = 0.024 and P < 0.001, respectively). However, there was no association found between serum selenium and other pregnancy outcomes. Conclusion: HIV-positive pregnant women had a lower mean serum selenium level compared to HIV-negative pregnant women. There was a significant association between low maternal serum selenium level and maternal anemia, as well as low birth weight, especially in HIV-positive pregnant women.

Résumé Contexte: L'infection par le virus de l'immunodéficience humaine (VIH) constitue une complication médicale majeure de la grossesse et est associée avec des issues fœto-maternelles défavorables. Cependant, la relation entre les niveaux de sélénium sérique maternel et les résultats de la grossesse aété incohérent. Objectif: Cette étude visait à déterminer la relation entre le statut maternel en sélénium sérique et la grossesse résultat chez les femmes séropositives et séronégatives dans un établissement de santé tertiaire Méthodologie: une étude transversale comparative a été menée auprès de femmes enceintes séropositives et séronégatives dans un établissement de soins de santé tertiaires à Owerri. Les participants étaient recrutés dans la salle de travail et interrogés à l'aide d'un questionnaire structuré. Cent dix femmes enceintes séropositives ont été comparativement à un nombre égal de femmes enceintes séronégatives. Elles ont été appariées pour l'âge, la parité et l'âge gestationnel. Le niveau de sélénium a été mesuré à l'aide d'un spectrophotomètre d'absorption atomique. L'hématocrite maternel (PCV) a également été évalué à recrutement. À l'accouchement, le poids à la naissance a été mesuré à l'aide d'une balance standard et documenté. Des cas de naissances prématurées, de décès périnataux, d'anomalies congénitales majeures et d'admissions néonatales ont été notés et également documentés. L'analyse statistique a été effectuée à l'aide des moyennes et des normes déviation. Le test du chi carré, le test t de Student, la régression logistique et la corrélation de Pearson ont également été utilisés. La signification statistique était considéré à P < 0,05. Résultats: Les femmes enceintes séropositives avaient une concentration sérique moyenne de sélénium significativement plus faible que avec des femmes enceintes séronégatives (64,3 ± 19,6 µg/L vs 100,1 ± 30,9 µg/L ; P < 0,001). Il y avait une association statistiquement significative entre la concentration sérique de sélénium et le poids à la naissance chez les femmes enceintes séropositives et séronégatives (P < 0,001). De la même manière, une association statistiquement significative a été observée entre le sélénium sérique et l'hématocrite maternel chez les femmes enceintes séropositives et séronégatives.femmes (P = 0,024 et P < 0,001, respectivement). Cependant, aucune association n'a été trouvée entre le sélénium sérique et d'autres grossesses. Résultats. Conclusion: les femmes enceintes séropositives avaient un taux sérique moyen de sélénium par rapport aux femmes enceintes séronégatives femmes. Il y avait une association significative entre la faible taux sérique de sélénium et anémie maternelle, ainsi que faible taux de naissance poids, en particulier chez les femmes enceintes séropositives. Mots-clés: enceinte séronégative pour le virus de l'immunodéficience humaine femmes, femmes enceintes séropositives pour le virus de l'immunodéficience humaine, taux de sélénium maternel, résultat de la grossesse.

The magnitude and predictors of cervical squamous intraepithelial lesions among women in Enugu, Nigeria: a cross-sectional study of women in a low-resource setting.

Introduction: the prevalence of cervical squamous intraepithelial lesion is not well appreciated in most low-income countries. The study aimed to determine the level of awareness, prevalence and the pattern of squamous intraepithelial lesions and predictors for abnormal Pap smear reports (development of pre-malignant lesions of the cervix) among women attending various clinics in a tertiary health facility in Enugu, Nigeria. Methods: a cross-sectional study of 207 female patients attending various clinics of Enugu State University Teaching Hospital, Parklane, Enugu between June and August 2017 was undertaken. Structured interviewer-administered questionnaires were used for data collection while cervical smears were collected from the patients and sent for cytology. Data analysis was done using the Statistical Package for the Social Sciences (SPSS) version 22.0. The results were presented as means, standard deviations, frequencies and proportions. Pearson´s Chi-square test was used to test for associations between categorical variables and statistical significance was set at a p-value of < 0.05. Results: the levels of awareness of cervical cancer and the screening methods among the respondents were 76.8% and 36.7% respectively. The overall knowledge of cervical cancer and its screening was poor (6.8% and 29.0% respectively). The prevalence of pre-malignant lesions of the cervix among the respondents was 15.0% with low grade squamous intraepithelial lesion (LGSIL) having the highest frequency (38.7%). Among all the other risk factors for the development of premalignant lesions of the cervix among the respondents, a report of abnormal pap (positive) smear report was significantly associated with only age ≥35 years (χ2=5.723; p=0.017). The same age of 35 years and above also correctly predicted abnormal Pap smear reports among other factors (AOR = 3.02, 95% CI = 1.16 - 7.89, p = 0.024). Conclusion: the awareness of cervical cancer and cervical cancer screening was high but the overall knowledge on cervical cancer and its screening was very poor among the respondents. The prevalence of pre-malignant lesions of the cervix was high, and the commonest abnormal smear was LGSIL. Only age 35 years and above correctly predicted the occurrence of abnormal Pap smear reports among the respondents.