Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study.

BACKGROUND: The prevalence of pregnancy-induced hypertension in Ethiopia ranges from 2.2 to 18.3%. However, so far little is known about the adverse perinatal outcomes of pregnancy-induced hypertension in Tigray regional state, Ethiopia. Therefore, the objective of this study was to assess the effect of pregnancy-induced hypertension on adverse perinatal outcomes in Tigray Regional State, Ethiopia. METHODS: a prospective cohort study was conducted on a total sample of 782 pregnant women attending antenatal care in hospitals of Tigray regional state, Ethiopia. Pregnant mothers diagnosed with PIH during the data collection period in the selected hospitals were included as exposed group and normotensive women were also enrolled as a control group. This study addresses women diagnosed with preeclampsia, eclampsia and gestational hypertension between 28 and 35 weeks of gestation. Data were collected using an interviewer-administered questionnaire and review of their medical records from February 2018, to February 2019. The adverse perinatal outcome event includes low birth weight, birth asphyxia, small for gestational age, preterm delivery, admission to neonatal intensive care unit and perinatal death. A modified Poisson regression model with robust standard errors was used to analyze relative risk. RESULTS: In this study, the overall incidence of adverse perinatal outcome was higher among women with pregnancy-induced hypertension than normotensive women (66.4% vs 22.2%). After adjusted for confounders women with pregnancy-induced hypertension were born babies with a higher risk of low birth weight (adjusted RR (95%CI) = 5.1(3.4,7.8)), birth asphyxia (aRR = 2.6(1.9,3.8)), small for gestational age (aRR = 3.3(2.3,4.6)), preterm delivery (aRR = 5.2(3.4,7.9)), stillbirth (aRR = 3.46(1.40,8.54)), admission to neonatal intensive care unit (aRR = 5.1(3.1,8.4)) and perinatal death (aRR = 3.6(1.8,7.4)) compared to normotensive pregnant women. CONCLUSIONS: Higher incidences of adverse perinatal outcomes occurred among women pregnancy-induced hypertension in Tigray regional state, Ethiopia. Hence, health care providers should strengthen prevention, early diagnosis and prompt management of pregnancy-induced hypertension to reduce adverse perinatal outcomes of pregnancy-induced hypertension.

Hepatitis B Virus Prevalence among HIV-Uninfected People Living in Rural and Peri-Urban Areas in Botswana.

(1) Background: we determined the prevalence of the hepatitis B virus (HBV) amongst people without human immunodeficiency virus (HIV) in rural and peri-urban areas in Botswana. (2) Methods: We screened for the hepatitis B surface antigen (HBsAg) from archived plasma samples of people without HIV (n = 2135) randomly selected from the Botswana Combination Prevention Program (BCPP) (2013-2018). We sequenced 415 bp of the surface region using BigDye sequencing chemistry. (3) Results: The median age of participants was 31 (IQR: 24-46) and 64% (1360/2135) were female. HBV prevalence was 4.0% (86/2135) [95% CI: 3.3-4.9]) and ranged between 0-9.2%. Older participants (>35 years) had increased odds of HBV positivity (OR: 1.94; 95% CI: [1.32-2.86]; p = 0.001). Thirteen samples were sequenced and seven (53.8%) were genotype A, three (23.1%) were genotype D and genotype E each. Clinically significant mutations were identified in the surface region, but no classic drug resistance mutations were identified. (4) Conclusions: We report an HBV prevalence of 4.0% (95% CI 3.3-4.9) among people without HIV in rural and peri-urban communities in Botswana with varying rates in different communities. A comprehensive national HBV program is required in Botswana to guide HBV prevention, testing and management.

Knowledge of the human papilloma virus vaccines, and opinions of gynaecologists on its implementation in Nigeria.

The objective of this study was to determine the knowledge and perception of Nigerian Obstetricians and Gynaecologists towards human papilloma virus vaccine use in Nigeria. A cross sectional study was conducted amongst participants that attended the 42nd Society of Gynaecology and Obstetrics of Nigeria. The findings revealed that 44.5% knew the correct HPV vaccine schedule. Regarding implementation in Nigeria, 87.4% suggested its incorporation into the national immunization program and about a third agreed that it should be a precondition for school enrolment. Regression analysis showed that senior residents were more likely to have adequate knowledge of the vaccine compared to junior residents (AOR 7.181 95% CI OR = 1.792 - 28.782). We conclude that the knowledge of eligibility and schedule is poor. It is recommended that adequate information should be provided to this group of health workers because of their strategic position in its implementation in Nigeria.

The risk of prematurity in Cameroonian children born after in vitro fertilisation.

Objective: To evaluate the risk of prematurity in Cameroonian children born after in vitro Fertilisation. Design: A retrospective cohort study. Setting: Conducted at the pediatric department of the Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction (HCRAESHR) in Yaoundé over eight months. Participants: Every newborn born after in vitro fertilisation (exposed group) and those born after spontaneous conception (non-exposed group) from a singleton pregnancy were included. Multiple pregnancies were excluded. One hundred newborns per group were recruited and matched according to the mode of delivery. Interventions: The main outcome measure was prematurity at birth. Data were collected from the medical records of the newborns and reported on individual questionnaires. The t Student test was used to assess the differences in gestational age between the two groups. The generalised linear model using binomial probability distribution was used for multivariate analysis to determine prematurity risk factors. All results with a p-value ≤ 0.05 were considered statistically significant. Results: Prematurity was significantly predominant in the exposed group (22% and 5%, respectively, p=0.002) compared to the non-exposed group. The risk of prematurity in the exposed group was 4.4 times higher than in the non-exposed group. After controlling for confounders (the maternal age, the sex of the baby, and maternal hypertension), this risk increased significantly from 4.4 to 7.67 (p=0.001). Conclusion: This study demonstrated the first evidence from our part of the world showing that in vitro fertilisation is an absolute risk of prematurity. Funding: None declared.

Female Genital Tuberculosis Among Infertile Women and Its Contributions to Primary and Secondary Infertility: A systematic review and meta-analysis.

Female genital tuberculosis (FGTB) is a widespread infectious disease among young women. This meta-analysis aimed to investigate the prevalence of FGTB among infertile women and its contribution to primary and secondary infertility. PubMed, MEDLINE®, WorldCat, The Lens, direct Google search, Google Scholar and ResearchGate were searched from 1971 to July 17, 2021 using the following terms: "prevalence", "epidemiology", "urogenital tuberculosis", "FGTB", "infertile women", "infertility complaints" and "FGTB testing methods". Data were extracted and a meta-analysis was performed. A total of 42 studies were selected with a total of 30,918 infertile women. Of these, the pooled prevalence of FGTB was 20% (95% confidence interval: 15-25%, I2 = 99.94%) and the prevalence of overall infertility, primary infertility and secondary infertility among FGTB population were 88%, 66% and 34%, respectively. The proportion of FGTB is remarkable among infertile women globally. The biggest burden of the disease is present in low-income countries followed by lower-to-middle- and upper-to-middle-income countries.

Influence of previous abortions and new paternity on the risk of hypertension in nulliparous parturients in Ibadan: a cohort study.

AIM: This study aims to determine the influence of previous abortions and new paternity on the risk of hypertension in a cohort of nulliparous women. METHODS: A prospective cohort study was conducted with development of hypertension in pregnancy as outcome variable. Explanatory variables were previous abortions and paternity. Univariate analysis was by t-test, χ(2) test and Fisher's exact test where applicable. Logistic regression was utilized for multivariate analysis. Stata was utilized for all the analyses. The level of statistical significance was set as P < 0.05. RESULTS: Same paternity abortions reduced the risk of hypertension (OR 0.48, 95% CI 0.31-0.73). Previous abortions did not reduce the odds of hypertension in pregnancy (OR 1.25, 95% CI 0.83-1.88). Rural dwelling reduced the odds of developing hypertension in pregnancy (OR 0.54, 95% CI 0.42-0.70). CONCLUSION: The result of this study supports the immunological theory of the etiology of hypertension in pregnancy.

Influence of duration of sexual cohabitation on the risk of hypertension in nulliparous parturients in Ibadan: A cohort study.

BACKGROUND: Hypertensive disorders of pregnancy are an important cause of maternal mortality in this environment, it accounts for about 20% of all maternal deaths in pregnancy in Nigeria. AIM: This study aims to determine the effect of the length of sexual cohabitation on the development of hypertension in pregnancy in a Nigerian population. MATERIALS AND METHODS: The study was a prospective cohort study; three centres were involved in the study between July 2006 and February 2009. For this study, the main outcome variable was the development of Hypertension in pregnancy. The main explanatory variable was the length of preconception sexual cohabitation. Univariate analysis was by t test, chi-squared test and Fisher's exact test for continuous and categorical variables. Multivariate analysis was by Cox hazard regression. RESULTS: In the study population, the incidence of gestational hypertension and pre-eclampsia were 28.93% and 4.13% respectively, 29.64% had previous abortions and same paternity abortion rate was 25.92%. Length of sexual cohabitation before index pregnancy was protective against hypertension in pregnancy but not for pre-eclampsia; there was a 4% decrease in the risk of developing hypertension for every month increase in cohabitation (hazard ratio, HR 0.96 (95% CI 0.93-0.99)). Also protective in this model was same paternity abortion with a HR of 0.71 (95% CI 0.55-0.93). A previous abortion was not protective (HR 1.05 (95% CI 0.82-1.35)). CONCLUSION: It was concluded that increased length of sexual cohabitation prior to conception reduces the risk of gestational hypertension.

Awareness of pregnancy induced hypertension among pregnant women in Tigray Regional State, Ethiopia.

INTRODUCTION: Pregnancy-induced hypertension is among the leading cause of maternal mortality in Tigray regional state, Ethiopia. However, there was no study in this study area about awareness of pregnancy induced hypertension among pregnant women. Therefore, the aim of this study was to assess awareness of pregnancy induced hypertension among pregnant women. METHODS: A cross-sectional study design was conducted on a total of 798 pregnant women attending antenatal care in general hospitals of Tigray Regional State. Data were collected from February to November 30, 2018. Binary logistic regression analysis was used to determine factors associated with poor awareness and p-values < 0.05 was considered as statistically significant. RESULTS: A total of 792 pregnant women were included in this study with a response rate of 99.2%. In this study, 41.8% of pregnant women were having poor awareness of pregnancy-induced hypertension. Primigravida, women with no formal education, women with the lowest wealth status and occupation of a housewife were significantly associated with poor awareness. Additionally, there was a significant difference in the mean score of awareness of pregnancy-induced hypertension between normotensive women and women with pregnancy-induced hypertension (Mean score difference (95% CI) = 1.90(1.35, 2.45), t = 6.75, df = 790, p < 0.001)). CONCLUSION: A high proportion of pregnant women had poor awareness on pregnancy-induced hypertension. Health care providers should improve awareness of pregnant women about pregnancy-induced hypertension in antenatal care clinics and at a community level with a special focus of awareness on primigravida women, women with no formal education, women with lowest wealth status and housewives.

Effect of pregnancy and childbirth on sexuality of women in ibadan, Nigeria.

A study of 375 antenatal attendees to assess women's views and experience in sexual matters during pregnancy and following childbirth. Explanatory variables included the perception women had of sex during pregnancy and after childbirth. Outcome variables were frequency and satisfaction of sexual activity. The commonest reasons for having coitus in pregnancy were marital harmony and facilitation of delivery. Libido rose throughout pregnancy but orgasms were less often experienced. The man-on-top position became less practised. Vaginal intercourse remained the commonest type. Masturbation and anal intercourse increased, while oral sex declined throughout. Marriage (OR 9.0, 95% CI 1.0-79.5) and current cohabitation (OR 13.6, 95% CI 1.6-113.4) were predictors of sex in pregnancy. Dyspareunia and partners' extramarital affairs were deterrent. Vaginal delivery and episiotomy were not significant predictors of postnatal sex. The respondents and their partners seem able to adapt to pregnancy changes and enhance their marital bonds. Anticipatory guidance and informed counselling may encourage this.