Iron deficiency and thyroid dysfunction among sudanese women in first trimester of pregnancy: a cross-sectional study.

BACKGROUND: Pregnant women are more susceptible to iron deficiency (ID), and it can lead to several maternal and perinatal adverse effects. There are some published data on the effect of ID on thyroid function, but none of the studies were conducted in sub-Saharan African countries including Sudan. This study was conducted to investigate association between ID (ferritin < 15 µg/L) and thyroid functions [thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4)] among Sudanese women in the first trimester of pregnancy. METHOD: A cross-sectional study was conducted in Saad Abuelela Maternity Hospital, Sudan. Obstetric/sociodemographic characteristics were gathered through questionnaires. Hemoglobin, serum ferritin, TSH, FT3, and FT4 were measured in all pregnant women. Continuous variables were compared with either independent sample t-test if they were normally distributed, or with Mann-Whitney U- test if they were not-normally distributed. Spearman correlations were performed between the continuous variables. RESULTS: In total, 127 pregnant women with mean [standard deviation (SD)] age of 27.0 (5.5) years and gestational age of 10.5 (3.0) weeks, respectively, were enrolled in this study. Forty-seven (37.0%) of these 127 women had ID. While the median [interquartile range (IQR)] of the parity, TSH, and FT3 were not different between women with ID and women without ID, the median (IQR) of FT4 was significantly lower in women with ID compared with women without ID [1.020 (0.910‒1.120) vs. 1.095 (0.990‒1.217) pmol, P = 0.014]. Serum ferritin was inversely correlated with FT3, (r = -0.225, P = 0.011). There was no significant correlation between serum ferritin, TSH, and FT4. CONCLUSIONS: Iron deficiency was common during the first trimester of pregnancy and was associated with thyroid dysfunctions. Therefore, ID should be evaluated to avoid thyroid dysfunction.

Prevalence of Low Birth Weight and its Association With Anemia in White Nile State, Sudan: A Cross-Sectional Study.

Introduction: Low birth weight (LBW) remains a global health concern, especially in sub-Saharan African countries with fewer resources, such as Sudan. Despite ongoing preventive measures, LBW is still one of the main health problems and it is a leading risk factor for several adverse perinatal and neonatal outcomes. Objective: To assess the prevalence of and factors associated (mainly maternal anemia) with LBW at Rabak Maternity Hospital, White Nile, Central Sudan. Methods: A cross-sectional study was conducted involving live singleton newborns and their mothers who presented to Rabak Maternity Hospital from September to December 2021. Questionnaires were completed via face-to-face interviews to gather maternal information (maternal age, parity, history of miscarriage, educational status, and level of antenatal care [ANC]). Maternal hemoglobin levels were measured using an automated hematology analyzer. The neonate's birth weight and sex were recorded. Results: Two hundred and fifty-three newborns were enrolled in this study, 40 (15.8%) of whom were LBW neonates. The median (interquartile range) maternal age and parity were 25 (21.0-30.0) years and 2 (1-4), respectively. While gestational age, maternal hemoglobin, and maternal anemia were associated with LBW, maternal age, parity, a history of miscarriage, education level, and level of ANC were not associated with LBW in the univariate analysis. Multivariate analysis showed that gestational age (adjusted odds ratio [AOR] = 0.80, 95% confidence interval [CI] = 0.66-0.96) and maternal hemoglobin (AOR = 0.76, 95% CI = 0.52-0.86) were inversely associated with LBW. Maternal anemia was associated with LBW (AOR = 4.70, 95% CI = 2.06-10.94). Conclusion: LBW is a major health concern in White Nile, Sudan. Maternal age and maternal anemia are associated with LBW. Preventive measures for managing maternal anemia may help reduce the incidence of LBW.

History of maternal migraine and its association with preeclampsia: A case-control study in a low-resource setting in Sudan, Africa.

BACKGROUND: Previous studies have reported various levels of association between migraine and preeclampsia. However, there are no published data on migraine and its association with preeclampsia in African countries, including Sudan. METHODS: A case-control study was conducted at Rabak Maternity Hospital in White Nile State, Central Sudan. The cases were pregnant women with preeclampsia, while the controls were healthy pregnant women. All participants were interviewed using questionnaire. The adjusted odds ratio (AOR) and a 95% confidence interval (CI) were calculated in a multivariate regression analysis. RESULTS: Of 148 pregnant women with preeclampsia, 96 (64.9%) women had mild preeclampsia and 52 (35.1%) women had severe preeclampsia. Of the 148 study participants with preeclampsia, 57 (38.5%) had a history of migraine and 19/296 (6.4%) women in control group had a history of migraine (p < 0.001). Pregnant women with a history of migraine have higher odds of preeclampsia than pregnant women without a history of migraine (AOR = 9.01, 95% CI = 4.81-16.86). A history of preeclampsia, being overweight and obesity were associated with preeclampsia. CONCLUSION: Our findings are consistent with the findings of previous studies on the association between migraine and preeclampsia. More studies are needed on this topic.

Prevalence and Associated Risk Factors for Anemia in Pregnant Women in White Nile State, Sudan: A Cross-Sectional Study.

Introduction: Anemia during pregnancy can lead to several adverse maternal and perinatal outcomes. Despite preventive measures, anemia during pregnancy remains a threatening health problem, especially in sub-Saharan African countries. Objective: We aimed to determine the prevalence of, and factors associated with, anemia among pregnant women at Rabak Maternity Hospital, Sudan. Methods: We conducted a cross-sectional study involving pregnant women who presented to Rabak Maternity Hospital from September to December 2021. Questionnaires were completed via face-to-face interviews to gather both obstetric and sociodemographic information (i.e., age, parity, history of miscarriage, education, level of antenatal care), and hemoglobin levels were estimated. A logistic regression analysis was performed. Results: The median (interquartile range) of the age and parity of the 208 women enrolled in the study was 25 (21.0-30.0) years and 2 (1-4), respectively. Forty-five (21.6%) women did not use iron-folic acid during the index pregnancy. Eighty-eight (42.3%) women had anemia, and four (1.9%) had severe anemia. In the univariate analysis, age, parity, history of miscarriage, interpregnancy interval, education, and antenatal care level were shown not to be associated with anemia. A higher number of women with anemia did not use iron-folic acid during the index pregnancy than those without anemia (29/80 [33.0%] vs. 16/120 [13.3%], respectively, p = .001). Not taking iron-folic acid was found to be associated with anemia in the multivariate analysis (adjusted odds ratio = 3.19, 95% confidence interval = 1.60-6.63). Conclusion: Anemia was found to be a major health problem among the pregnant women in this study. There is no clear evidence across the women with anemia that their anemia stems from lack of using iron-folic acid (in fact, some women used iron-folic acid and they were anemic). There is a possibility that using iron-folic acid may prevent anemia in this part of Sudan.

The association between female newborn and placental malaria infection: A case-control study.

INTRODUCTION: There are few published data on the influence of the sex of the fetus or the newborn on the rate of malaria infection. Moreover, the results of these studies are not conclusive. This study was conducted to investigate the association between sex of the newborn and placental malaria infection. METHODS: A case-control study was conducted at Al Jabalian maternity hospital in central Sudan during the rainy and post rainy seasons from May to December 2020. The cases were women who had placental malaria, while the controls were subsequent women who had no placental malaria. A questionnaire was filled out by each woman in the case and control groups in order to gather demographic data as well as medical and obstetric history. Malaria was diagnosed using blood films. Logistic regression analyses were performed. RESULTS: There were 678 women in each arm of the study. Compared with the women without placental malaria (controls), women with placental malaria had a significantly lower age and parity. A significantly higher number of the cases had delivered female newborns, 453 (66.8%) vs. 208 (30.7%), P < 0.001. In logistic regression, women with placental malaria: lived in rural areas, had low antenatal attendance, did not use bed nets, and had more female newborns (adjusted odds ratio, AOR = 2.90, 95% CI = 2.08-4.04). DISCUSSION: Women who delivered female were more likely to have placental malaria. Further research into the immunologic and biochemical parameters is warranted.

Evaluation of the association between haemoglobin levels and preterm birth at Khartoum, Sudan: A hospital-based study.

Objective: The objective of this study was to determine the association between haemoglobin level and PB. Methods: A cross-sectional study was conducted in Khartoum, Sudan. Questionnaires on demographics and medical and obstetric factors were completed. A logistic regression analysis was performed. Results: Of the 1,716 pregnant women, approximately two-thirds (65.7%) had anaemia (haemoglobin < 11 g/dl) and six (0.3%) had severe anaemia (haemoglobin < 8 g/dl). Of the 1,716 women, 283 (16.5%) had a PB. In multivariable logistic regression, parity (AOR = 1.15, 95% CI = 1.09-1.21, P < 0.001) was positively associated with PB. Compared to those with haemoglobin levels of 10-10.9 g/dl, pregnant women with haemoglobin levels of 8-8.9 (AOR = 0.41, 95% CI = 0.22-0.77), 9-9.9 (AOR = 0.59, 95% CI = 0.38-0.91), and 11-11.9 g/dl (AOR = 0.53, 95% CI = 0.36-0.77) were at a lower risk of PB. Women with haemoglobin levels of 12-13 g/dl were at a higher risk of PB (AOR = 1.62, 95% CI = 1.06-2.45). There was no significant association between women with haemoglobin levels < 8 g/dl and > 13 g/dl and PB. Conclusion: This study showed different levels of association between haemoglobin levels and PB.

Maternal age and miscarriage: A unique association curve in Sudan.

This study's aim was to estimate the prevalence and maternal age and other risk factors of miscarriage among Sudanese women. A cross-sectional study was conducted at the Saad Abuelela Tertiary Hospital in Khartoum, Sudan, from February to December 2019. Sociodemographic, obstetric and clinical data were collected. A multivariate logistic regression analysis was performed. Four hundred thirteen (20.5%) women reported experiencing a miscarriage. Risk factors included older age, high parity, histories of caesarean delivery, and obesity. Logistic regression showed that the lowest risk for women aged less than 20 years (adjusted odds ratio [AOR], 0.33) or 20 to 24 years (AOR, 0.57), primiparas (AOR, 0.42) and women educated below the secondary level (AOR, 0.78). Unlike the global age-associated risk of miscarriage, the risk of miscarriage among Sudanese women follows a unique curve in relation to maternal age. Interestingly, the curve showed a lower risk for women less than 20 years and at 40 years.

High level of hemoglobin, white blood cells and obesity among Sudanese women in early pregnancy: a cross-sectional study.

AIM: To investigate the association between obesity and anemia/hemoglobin levels. MATERIAL & METHODS: A cross-sectional study was conducted at Khartoum, Sudan. Obstetric data were collected from 388 pregnant women at mean (standard deviation) of 10.5 (3.1) weeks of gestation using questionnaires. Weight and height were determined, and BMI was calculated. RESULTS: There were 15 (4.4%), 95 (28.1%), 127 (37.6) and 101 (29.9%) women who were underweight, normal weight, (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2) and obese (≥30 kg/m2), respectively. Hemoglobin levels and white blood cell counts were significantly higher in obese than nonobese groups. Compared with normal BMI, overweight and obesity were associated with higher hemoglobin level. CONCLUSION: Obese women had higher white blood cell count and hemoglobin level.

O Blood Group as a Risk Factor for Helicobacter Pylori IgG Seropositivity Among Pregnant Sudanese Women.

The objective was to investigate the prevalence and the association between blood groups and Helicobacter pylori IgG seropositivity among pregnant Sudanese women. A cross-sectional survey was carried-out at Saad Abul Ela Maternity Hospital, Khartoum, Sudan during the period of July 2014 through December 2015. Questionnaires covering socio-demographic and obstetrics information were administered. Specific H. pylori IgG antibody was analysed using ELISA. One hundred eighty six pregnant women were enrolled. The mean (SD) of the age, parity was 28.3 (2.6) years and 2.6 (3.5), respectively. Of the 186 women, 42 (22.6%), 24 (12.9%), 11(5.9%) and 109 (58.6%) had blood group A, B, AB and O, respectively. H. pylori IgG seropositivity rate was 132/186 (71.0%). There was no significant difference in age and parity between women with H. pylori IgG seropositive and seronegative. Compared with the women with H. pylori IgG seronegative, significantly higher numbers of women with H. pylori IgG seropositive had O blood group, [84/132(63.6) versus 25/54(46.3), P<0.001]. In binary logistic regression, women with O blood group (OR= 2.084, 95% CI=1.060-4.097, P=0.033) were at a higher H. pylori IgG seropositivity. The current study showed that women with blood group O were at higher risk for H. pylori IgG seropositivity.

O Blood Group as Risk Factor for Preeclampsia among Sudanese Women.

AIM: To investigate blood groups and the other possible risk factors for preeclampsia among Sudanese women. MATERIAL AND METHODS: A case - control study was conducted at Saad Abualila Hospital, Khartoum, Sudan during the period of July 2013 through December 2014. The cases were women with preeclampsia and healthy pregnant women were the controls. RESULTS: Two hundred eighty pregnant women were enrolled (140 in each arm of the study). Around one-quarter of all women (280) were primiparae (74.0, 26.4%), the majority were housewives (201, 71.7%). Seventy-nine (28.2%) were illiterate or had no informal education. Around half of the women (130, 46.4%) had O blood group. Binary logistic regression showed association between preeclampsia and lack of antenatal care (OR = 2.75, 95% CI = 1.172-6.494, P = 0.020) as well as O blood group (OR = 1.78, 95% CI = 1.088-2.934, P=0.022). CONCLUSION: The current study showed that women with blood group O were at higher risk of preeclampsia.

Serum Calcium, Magnesium, Zinc and Copper Levels in Sudanese Women with Preeclampsia.

BACKGROUND: Although the exact pathophysiology of preeclampsia is not fully understood, several elemental micronutrient abnormalities have been suggested to play a contributory role in preeclampsia. AIMS: To investigate the levels of calcium, magnesium, zinc and copper in women with preeclampsia. SUBJECTS AND METHODS: A case-control study was conducted in Omdurman Maternity Hospital, Sudan, during the period of September through December 2014. The cases were women with preeclampsia while healthy pregnant women were the controls. The medical and obstetrics history was gathered using questionnaires. The serum levels of calcium, magnesium, zinc and copper were measured using atomic absorption spectrophotometer. RESULTS: There was no significant difference between the two groups in their age, gestational age, parity and body mass index. Zinc and copper levels were not significantly different between the two groups. In comparison with the controls, women with preeclampsia had a significantly lower median (inter-quartile) serum calcium [7.6 (4.0─9.6) vs. 8.1 (10.6─14.2), mg/dl, P = 0.032] and higher levels of magnesium [1.9 (1.4─2.5) vs. 1.4 (1.0─1.9) mg/dl; P = 0.003]. In binary logistic regression, lower calcium (OR = 0.73, 95% CI = 0.56 ─ 0.95, P = 0.021) and higher magnesium (OR = 5.724, 95% CI = 1.23 ─ 26.50, P = 0.026) levels were associated with preeclampsia. There were no significant correlations between levels of hemoglobin and these trace elements. CONCLUSION: The current study showed significant associations between preeclampsia and serum levels of calcium and magnesium.