Impact of Binet Staging versus Tumour Bulk on Treatment Outcome in Chronic Lymphocytic Leukaemia.

BACKGROUND: Most of the predictive tools put up to prognosticate treatment outcomes in patients with chronic lymphocytic leukaemia (CLL) are not easily available and affordable in our resource-constrained environment. AIM: The aim of this study was to evaluate the impact of staging and some tumour bulk on treatment outcomes of persons with CLL, Enugu, Nigeria. PATIENTS AND METHODS: This is a 10-year review of the CLL data from the haemato-oncology unit of a Nigerian tertiary hospital to evaluate the impact of staging and tumour bulk indicators. Data were retrieved from the case notes of 102 patients with CLL receiving care at the facility. Data of interest include basic demographic variables, clinical features including spleen size and disease staging and blood counts. Statistical analysis was done using SPSS version 22. RESULTS: The median absolute lymphocyte count (ALC) was 108.05 (confidence interval [CI] = 50.8-201.3, interquartile range [IQR] = 124.4) ×109/L, and duration of survival for the study cohort was 5.5 (CI = 3.5-31.9, IQR = 27) months. Majority (69, 79.3%) were in Stage C. The Binet stage showed a significant association with the ALC (r = 0.338; P = 0.002) but not with spleen size (r = 0.198; P = 0.056). The duration of survival only showed a significant inverse relationship with the ALC (r = 0.35, P = 0.006) but with neither the Binet stage (r = 0.103, P = 0.431) nor spleen size (r = 0.184, P = 0.116). CONCLUSION: In CLL patients, ALC at presentation correlates with the duration of survival. We recommend that the ALC at presentation be used as a prognostic marker in our clime.

Serum leptin levels and relationship with maternal weight gain at term among obese and non-obese pregnant women in Enugu, Nigeria: a comparative cross-sectional study.

OBJECTIVE: To determine and compare the mean maternal serum leptin levels, the prevalence of high serum leptin levels and mean gestational weight gain at term among obese and non-obese pregnant women in Enugu, Nigeria. METHODS: This cross-sectional comparative study enrolled obese and non-obese pregnant women. The serum leptin levels of the women were determined using an enzyme-linked immunosorbent assay kit. Anthropometric and sociodemographic data were obtained and compared. Mean weight gain during pregnancy was determined. RESULTS: A total of 170 pregnant women were included in the study. The mean ± SD serum leptin level (99.39 ± 50.2 ng/ml) and the prevalence of hyperleptinaemia (81 of 85 patients; 95.3%) among the obese pregnant women at term were significantly higher than those of the non-obese pregnant women (48.98 ± 30.35 ng/ml/65 of 85 patients; 76.5%). The mean percentage weight gain was significantly higher in the non-obese women compared with the obese women at term. The predictors of high maternal serum leptin level at term among the participants were the employment status and levels of education of the participants. CONCLUSION: Maternal serum leptin level, maternal weight gain and prevalence of hyperleptinaemia at term were significantly higher in the obese compared with the non-obese pregnant women.

Illustrated State-of-the-Art Capsules of the ISTH 2023 Congress.

This year's Congress of the International Society of Thrombosis and Haemostasis (ISTH) took place in person in Montréal, Canada, from June 24-28, 2023. The conference, held annually, highlighted cutting-edge advances in basic, translational, population and clinical sciences relevant to the Society. As for all ISTH congresses, we offered a special, congress-specific scientific theme; this year, the special theme was immunothrombosis. Certainly, over the last few years, COVID-19 infection and its related thrombotic and other complications have renewed interest in the concepts of thromboinflammation and immunothrombosis; namely, the relationship between inflammation, infection and clotting. Other main scientific themes of the Congress included Arterial Thromboembolism, Coagulation and Natural Anticoagulants, Diagnostics and Omics, Fibrinolysis and Proteolysis, Hemophilia and Rare Bleeding Disorders, Hemostatic System in Cancer, Inflammation and Immunity, Pediatrics, Platelet Disorders, von Willebrand Disease and Thrombotic Microangiopathies, Platelets and Megakaryocytes, Vascular Biology, Venous Thromboembolism and Women's Health. Among other sessions, the program included 28 State-of-the-Art (SOA) sessions with a total of 84 talks given by internationally recognized leaders in the field. SOA speakers were invited to prepare brief illustrated reviews of their talks that were peer reviewed and are included in this article. These illustrated capsules highlight the major scientific advances with potential to impact clinical practice. Readers are invited to take advantage of the excellent educational resource provided by these illustrated capsules. They are also encouraged to use the image in social media to draw attention to the high quality and impact of the science presented at the Congress.

Adherence to prophylaxis and bleeding outcome: A multicenter Nigerian study.

In Nigeria, low-dose prophylaxis is the standard of care as it reduces bleeding, development of target joints, arthropathy, and improvement of quality of life. Non-adherence or poor adherence can prevent the achievement of these outcomes. The levels and determinants of (non-)adherence among persons with haaemophilia (PWH) in Sub-Saharan Africa have not been evidenced. We aimed to evaluate self-reported adherence among PWH, provide evidence of determinants/predictors of adherence, and establish the associations between nonadherence and presence of target joints and annualized bleed rate. A cross-sectional survey of 42 participants on low-dose prophylaxis recruited during outpatient appointments in 5 haemophilia treatment centers in Nigeria. We used the validated Haemophilia Regimen Treatment Adherence Scale- Prophylaxis (VERITAS -Pro), 24 questions on six subscales (time, dose, plan, remember, skip, and communicate) questionnaire. The options of VERITAS -Pro were represented in a 5 Likert scale and the possible subscale ranged from 4 points (most adherent) to 20 points (least adherent) and the possible total score ranged from 24 (most adherent) to 120 (least adherent) the cutoff for overall adherence put at > 61 to indicate nonadherence. Information on the presence of target joints, the number of target joints, and annualized bleeding rates were collected from medical files. The mean age of the participants was 9.79 (6.29) years, with 96.6% having hemophilia A and 79.3% having target joints. Overall adherence to the prophylaxis regimen was 81.0%. The mean total VERITAS-Pro for the adherent group and the non-adherent group was 37.35 ±9.08 and 63.0± 6.37, respectively. The mean subscale scores for the adherent group ranged from 0.67 (communication) to 8.68 (planning), while the mean subscale scores range from 1.0 communication to 13.88 (planning) for the nonadherent group. The mean difference of all except the dosing subscale was statistically significant with p<0.05. Only the skipping subscale showed a statistically significant positive correlation with ABR in the non-adherent group p = 0.02. The findings indicate that adherence was very good, and most were in communication with their treatment centers. The skipping subscale was significantly associated with ABR for the nonadherent group. Interventions aimed at improving adherence are the key to better treatment outcomes. A multicenter study was needed to assess the reason for poor adherence.

Determinants of Obstetricians' Pattern of Care for Sickle Cell Disease in Pregnancy.

Background: Pregnancy in sickle cell disease (SCD) is high risk. With improved comprehensive obstetric care, pregnant females with SCD can achieve successful pregnancy outcomes, especially in resource-poor settings. Objectives: To determine the predictors of Obstetricians' pattern of care for SCD in pregnancy in Nigeria. Materials and Methods: Self-administered, pre-tested, pre-validated questionnaires containing 18 questions on demographic details of obstetricians, and their pattern of practice towards antenatal care for pregnant SCD patients were distributed to attendees of the 2018 conference of the Society of Obstetrics and Gynaecology of Nigeria (SOGON). Regression analysis was done to determine the possible predictors, and a significant level was <0.05. Result: Almost all the respondents (98.4%) considered pregnancy in SCD as high risk, and 96.2% proposed for preconception care in a tertiary hospital. The majority, (62%) agreed that antenatal visits in the first and second trimesters should be more frequent. The majority (96.2%) reported they would routinely order urine tests among other investigations. Majority of respondents,74.9% and 98.4% knew that foetal medicine specialists and haematologists should be part of preconception care team, respectively. Respondents' practice centre and designation, significantly contributed to their "willingness to consult a haematologist" (P = 0.004)," and willingness to consult a foetal specialist" (P = 0.047), while practice centre and practice population significantly contributed to their response to "ideal centre for management of SCD pregnancy": (P = 0.049), (P = 0.024) respectively. Conclusion: Obstetricians' level of training, practice centre, and practice population of pregnant women with SCD are significant contributors to their pattern of care towards antenatal care for pregnancy in SCD.

Prevalence of venous thromboembolism and its associations in a large racially homogenous population of sickle cell disease patients.

To determine the prevalence of venous thromboembolism (VTE) among adult sickle cell disease (SCD) patients in Nigeria. METHODS: This was a multicentre retrospective study in which the medical records of adult SCD patients were reviewed. Information on demographics, steady-state haemogram, clinical phenotypes, duration of follow-up, history of VTE including risk factors and management was collected. RESULTS: Of the 509 SCD patients with a median (IQR) duration of follow-up of 2 years, 10 (2.0%) had VTE (9 DVT and 1 PE). Their median (IQR) age was 27 (22.8-30.3) years. Identifiable risk factors for VTE included positive family history (2, 20%) surgery, splenectomy, paraplegia and cancer (1, 10% each). No risk factor was identifiable in four persons. VTE had no significant association with age and gender. VTE was significantly associated with the following events: acute chest syndrome [p = .002, odds ratio (OR) 8, 95% CI 2.2-28.9], osteonecrosis [p = .012, OR 5.24, 95% CI, 1.45-18.91] and vaso-occlusive crisis [p = .035]. Also significantly associated with VTE were pulmonary hypertension [p = .001, OR 23.3, 95%CI 5.18-105.06] and stroke [p = .032, OR 9.35, 95%CI 0.87-53.25]. CONCLUSION: The prevalence of VTE among SCD patients in Nigeria is low. It is significantly associated with vaso-occlusive crisis, pulmonary hypertension and stroke.

Clinical screening for menorrhagia and other bleeding symptoms in Nigerian women.

Objective: The objective of the study was to evaluate the prevalence of perceived bleeding symptoms in Nigerian women and the usefulness of a simple clinical screening tool for bleeding symptoms. Materials and Methods: A population-based cross-sectional survey of 1524 women of 16-50 years in Southeast Nigeria using a structured, prevalidated, pretested questionnaire was conducted. Results: A total of 1524 (85%) women responded with the mean age of 26 (10.6) years. Prevalence of bleeding symptoms was 24.6% and 11% of the women reported a positive family history of bleeding symptoms. There was a significant association between having a positive family history of bleeding disorder and experiencing bleeding symptoms (adjusted odds ratio: 0.12, 95% confidence interval: 0.06-0.22 P < 0.0001). Two hundred and six women experienced at least one bleeding symptom, 125 (8.2%) experienced at least two, whereas 43 (2.8%) experienced >3 bleeding symptoms. The most common perceived bleeding symptom was heavy menstrual bleeding (HMB) present in 83 women (22.2%), 141 (9.3%) reported a past history of HMB, 202 (13.3%) had heavy bleeds during most of their monthly cycle, and 351 (23%) requiring resuscitation with blood support. Conclusion: The prevalence of perceived bleeding symptoms among women is high, and HMB is the most common bleeding symptom. This clinical screening tool is easy and cost-effective in routinely identifying women with bleeding symptoms needing further hemostatic and obstetrics evaluation.

RésuméObjectif: L'objectif de l'étude était d'évaluer la prévalence des symptômes hémorragiques perçus chez les femmes nigérianes et l'utilité d'un outil de dépistage clinique simple des symptômes hémorragiques. Matériel et méthodes: enquête transversale auprès de la population auprès de 1 524 femmes de 16 à 50 ans dans le sud-est du Nigéria à l'aide d'un questionnaire structuré, prévalidé et prétesté. Résultats: Un total de 1524 (85%) les femmes ont répondu avec l'âge moyen de 26 (10,6) ans. La prévalence des symptômes hémorragiques était de 24,6% et 11% des femmes ont signalé un antécédents familiaux positifs de symptômes hémorragiques. Il y avait une association significative entre avoir des antécédents familiaux de saignement positifs trouble et présentant des symptômes hémorragiques (rapport de cotes ajusté: 0,12, intervalle de confiance à 95%: 0,06­0,22 P <0,0001). Deux cent et six femmes ont présenté au moins un symptôme de saignement, 125 (8,2%) en ont eu au moins deux, tandis que 43 (2,8%) ont eu> 3 saignements symptômes. Le symptôme de saignement perçu le plus courant était le saignement menstruel abondant (HMB) présent chez 83 femmes (22,2%), 141 (9,3%) ont signalé des antécédents de HMB, 202 (13,3%) ont eu des saignements abondants pendant la majeure partie de leur cycle mensuel et 351 (23%) ont dû être réanimés avec support sanguin. Conclusion: la prévalence des symptômes hémorragiques perçus chez les femmes est élevée et le HMB est le plus courant symptôme de saignement. Cet outil de dépistage clinique est simple et économique pour identifier systématiquement les femmes présentant des symptômes hémorragiques nécessitant évaluation hémostatique et obstétrique plus poussée.

Perception to hydroxyurea therapy in patients with sickle cell disease: Report from 3 centers.

Background: Hydroxyurea (HU) is an hemoglobin F inducing agent used in the treatment of sickle cell disease (SCD). Aim: The aim of this study is to determine the perception of HU by people living with SCD. Materials and Methods: A pretested questionnaire was self-administered to known cases of SCD attending pediatrics and adult hematology clinics in three participating centers. Mothers of children <18 years responded on their behalf. Results: There were 101 responders, 49 (48.5%) males and 52 (51.5%) females, of which 24 (23.8%) were children <18 years and 77 (76.2%) were adults. The majority (n = 73, 72.3%) knew their phenotype. Up to 63 (62.4%) had crises in the past 3 months. Only 35 (34.7%) had heard of HU, many through their doctor (n = 16, 45.7%), 8 (22.9%) through online resources, and 7 (20%) from friends. Only 12 (11.9%) had been exposed to HU therapy, of which 5 (41.7%) had discontinued therapy mostly due to side effects (n = 2, 40%). The seven patients (58.3%) on continuous HU therapy for a duration of 6 months to over 5 years, all reported reduced hospital admissions and frequency of crises as benefits of the drug, whereas 4 (57.1%) had stopped requiring blood transfusion since starting therapy. Of those who had never taken HU, 53 (52.5%) believed that HU should be used in treating SCD and majority (n = 32, 60.4%) would want to be commenced on the drug. However, 8 (15.1%) would decline therapy (mostly due to perceived associated side effects; n = 4; 50%). Six (11.3%) were unsure if they would want the drug and 7 (13.2%) would have to discuss the decision first with their family. There were 8 (8.9%) responders who did not think HU will be beneficial in SCD and would decline treatment, while 26 (29.2%) were unsure of both the benefits of the drug or of commencing therapy. Conclusion: The findings from this study suggest that HU is beneficial for patients with SCD; however, the awareness of this medication among SCD patients is still low in our environment. Some SCD patients would decline the use of HU due to perceived side effects. We recommend that more awareness on HU be created and coordinated multi-center studies on the efficacy of HU in the Nigerian population be carried out.

RésuméContexte: L'hydroxyurée (HU) est un agent inducteur de l'hémoglobine F utilisé dans le traitement de la drépanocytose (SCD). Objectif: le but de cette L'étude vise à déterminer la perception de l'HU par les personnes atteintes de SCD. Matériel et Méthodes: un questionnaire pré-testé a été auto-administré aux cas connus de SCD fréquentant des cliniques de pédiatrie et d'hématologie pour adultes dans trois centres participants. Les mères d'enfants de moins de 18 ans ont répondu en leur nom. Résultats: Il y avait 101 répondants, 49 (48,5%) hommes et 52 (51,5%) femmes, dont 24 (23,8%) étaient des enfants de moins de 18 ans et 77 (76,2%) étaient des adultes. La majorité (n = 73, 72,3%) connaissait leur phénotype. Jusqu'à 63 (62,4%) ont eu des crises au cours des 3 derniers mois. Seulement 35 (34,7%) avaient entendu parler de HU, beaucoup par l'intermédiaire de leur médecin (n = 16, 45,7%), 8 (22,9%) par des ressources en ligne et 7 (20%) par des amis. Seulement 12 (11,9%) avaient été exposés à un traitement par HU, dont 5 (41,7%) avaient arrêté le traitement principalement en raison d'effets secondaires (n = 2, 40%). Les sept patients (58,3%) sous traitement HU continu pendant une durée de 6 mois à plus de 5 ans, tous ont signalé une réduction des hospitalisations et de la fréquence des crises comme bienfaits du médicament, alors que 4 (57,1%) avaient cessé de nécessiter une transfusion sanguine depuis le début du traitement. De ceux qui n'avaient jamais prises HU, 53 (52,5%) estimaient que HU devrait être utilisée dans le traitement de la drépanocytose et la majorité (n = 32, 60,4%) souhaiterait commencer le médicament. Cependant, 8 (15,1%) refuseraient le traitement (principalement en raison des effets secondaires associés perçus; n = 4; 50%). Six (11,3%) ne savaient pas siils voudraient le médicament et 7 (13,2%) devraient d'abord discuter de la décision avec leur famille. Il y avait 8 répondants (8,9%) quine pense pas que l'HU sera bénéfique dans la drépanocytose et refuserait le traitement, tandis que 26 (29,2%) n'étaient pas certains des avantages du médicament ou commencer la thérapie. Conclusion: Les résultats de cette étude suggèrent que l'HU est bénéfique pour les patients atteints de SCD; cependant, la conscience de ce médicament chez les patients SCD est encore faible dans notre environnement. Certains patients SCD refuseraient l'utilisation de l'HU en raison du côté perçu effets. Nous recommandons qu'une plus grande sensibilisation à l'HU soit créée et coordonne des études multicentriques sur l'efficacité de l'HU au Nigéria. population être effectuée.

The Perception of People Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome toward Human Immunodeficiency Virus Infection: A Single-Center Experience.

BACKGROUND: The prevention and control of human immunodeficiency virus (HIV) infection depend on the prevention of new infections as well as treating currently infected individuals. Adequate knowledge of HIV infection among person living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA) may be an important tool in reducing spread of the virus. OBJECTIVE: The objective of the study was to evaluate knowledge and attitude of PLWHA on HIV infection. METHODOLOGY: This was a cross-sectional study conducted at the Chukwuemeka Odumegwu Ojukwu Teaching Hospital. Knowledge of infection, spread, control, and effect was sought from HIV-positive respondents using a structured questionnaire. Information about their attitude and beliefs was also obtained. Collected data were analyzed using the Statistical Package for Social Sciences for Windows, Version 21.0. RESULTS: A total of 70 HIV-positive patients, including 23 (32.9%) males and 47 (67.1%) females with a mean age of 37.7 years were participated. The overall knowledge on HIV transmission, clinical effects, complications, and controls was good in 15.7%, average in 72.9%, and poor in 11.4%. Knowledge of means of transmission was appropriate in majority of them. Majority of 66 (94.3%) patients showed a positive attitude to life. CONCLUSION: Most of the HIV-positive patients had average knowledge on HIV, and majority had a positive attitude to life.

Perception of problem based learning versus conventional teaching methods by clinical medical students in Nigeria.

INTRODUCTION: Problem-based learning (PBL) method which was introduced about 50 years ago in Canada is beginning to gain acceptance over conventional teaching method (CTM) worldwide in medical education but still remains unpopular in Nigeria. This study aims to determine the perception of clinical medical students to the use of both learning methods in pathology courses. METHODS: A cross-sectional quantitative survey was conducted in four Nigerian universities drawn from four regions of the country. Data were collected using pretested semi-structured self-administered questionnaires. RESULTS: The study included 310 respondents, 182(58.7%) males and 128(41.3%) females. Of all the participants, 257(82.9%) had heard of PBL prior to the study and 260(83.9%) thought it suitable for teaching and learning Pathology. Majority of participants, 221(71.3%) preferred a combination of both PBL and CTM while 238(76.8%) thought PBL suitable for all medical students. Some identified factors capable of enhancing adaptation of PBL into medical curriculum include conducive quiet spaces for learning and availability of computers with internet facilities for students' use. CONCLUSION: Participants demonstrated high level of awareness of PBL and thought it suitable for all medical students. Availability of computers and up-to-date libraries with internet and audio-visual facilities could enhance adaptation of PBL into medical curriculum in Nigeria.

Presenting features and treatment outcomes of chronic lymphocytic leukaemia in a resource poor Southern Nigeria.

Background: Chronic lymphocytic leukaemia is a relatively common haematological malignancy affecting older adults, accounting for about 20% of haematological malignancies in Nigeria. Diagnosis of this disease depends on the demonstration of clonal lymphocytosis > 5 × 109/L with a characteristic immunophenotypic pattern amidst other clinical and laboratory features. Objectives: To determine the predominant clinical and laboratory features of CLL at presentation and their relationship with patient survival. This study also aims at examining the relationship between treatment protocol and outcome. Methods: This is a retrospective study with 8 years data (2010-2018) collected from four different centers. Data was analyzed using SPSS 20.0. Results: There were a total of 97 cases, with a male: female ratio of 1.1:1. The median age at presentation was 59 years. Approximately 55% of the patients presented at Binet stage C, with splenomegaly in 93.2% and 78% were anaemic. The mean white cell count was 137.9 ± 14.7 × 109/L, with a median absolute lymphocyte count of 86 × 109/L. The commonest treatment regimen was chlorambucil and prednisolone and males had a superior response. The number of chemotherapy cycles, serum alkaline phosphatase and aspartate transaminase correlated positively with duration of survival. Mortality rate over the five year period was 14.3%. Conclusion: CLL was found to present in younger patients when compared to previous studies with a median age of 57 years at diagnosis. Our study showed a slight female preponderance and better response to therapy in males. Majority of the patients presented in Binet stage C and were treated with chlorambucil-based drug combinations compared to more current treatment with Fludarabine-based combinations. A high serum alanine transaminase and alkaline phosphatase was found to positively correlate with survival amongst this patient population.

Correlates of neutrophil/lymphocyte, platelet/lymphocyte, and platelet/neutrophil ratios of neonates of women with hypertensive disease of pregnancy with neonatal birth outcomes.

BACKGROUND: Studies have indicated neutrophil/lymphocyte ratio (NLR), Platelet/Lymphocyte ratio (PLR), and platelet/neutrophils ratio (PNR) to be inflammatory markers. The correlation of these values in infants of hypertensive mothers has not been investigated. AIM: To investigate the relationship between NLR, PLR, and PNR of neonates of women with hypertensive disease of pregnancy and neonatal APGAR scores and birth weight. METHODOLOGY: Cord blood samples of 200 neonates collected and the blood counts and ratios obtained. RESULTS: NLR in the babies of the hypertensive mothers was 0.865 and 1.42 in the control group (p = 0.0001). PLR was 34.7 in the neonates of the hypertensive mothers and 62.4 in the control group (p = 0.0001). PNR did not differ significantly between the two groups,p = 0.418. Degree of hypertension had a direct relationship with NLR; SBP had a p value of 0.001 while the DBP had p = 0.002. The PLR had an inverse relationship with the degree of hypertension; SBP p value of 0.0001, while DBP was p = 0.0001. No significant association was observed between the ratios and neonatal birth weight (p ≥ 0.05); however, PNR and PLR were found to be significantly associated with the 1st (p = 0.045 and 0.030) and 5th (0.049 and 0.037) minute APGAR scores in the newborns. CONCLUSION: PLR and NLR in neonates of hypertensive mothers are found to be markedly lower than those of controls, the degree of which is affected by the severity of hypertension. Also, lower PLR is associated with lower APGAR scores. Therefore, severity of high blood pressure and lower PLR may be determinants of poor birth outcome.

Impact of parity and gestational age of mothers with hypertension on birth weight, red blood cells and mode of delivery of their babies.

BACKGROUND: Maternal factors are determinants of birth outcome which includes birth weight, haematological indices and mode of delivery of their babies. OBJECTIVES: To determine the impact of parity and gestational age of hypertensive mothers on some neonatal variables. METHODS: A hospital based cross-sectional study of measurement of neonatal variables (birth weight, red blood cells and mode of delivery) among hypertensive mothers and their controls was conducted over a period of six months. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20. RESULTS: There were statistically significant differences in means between the neonates of the hypertensive group and non-hypertensive group for maternal age (t =1.61, p = 0.002), baby weight (t =2.87, p < 0.001), haemoglobin (Hb) (t =4.65, p = 0.010) and packed cell volume (PCV) (t =4.75, p = 0.009), but none for gravidity (t =1.95, p = 0.927)For all subjects, there was poor correlation between gestational age and variables; birth weight, haemoglobin (Hb), packed cell volume (PCV), nucleated red blood cell (nRBC) and parity. Likewise, parity poorly correlated with variables; age, birth weight, Hb, PCV, and nRBC. There was a statistically significant association between mode of delivery and hypertension (χ2 =53.082, p <0.001) but none with having a family history of hypertension (χ2 =1.13, p = 0.287). CONCLUSION: Parity and gestational age of mothers with hypertension have no impact on birth weight and red cells when compared with their non-hypertensive counterparts. However, mothers of babies delivered by elective and emergency caesarean section were about 2-3 times more likely to be hypertensive than those that delivered through spontaneous vertex delivery.

Correlation of hematocrit and Apgar scores in newborns of women with hypertensive disorders in pregnancy.

OBJECTIVES: To compare the incidence of polycythemia in newborns of women with hypertensive disorders in pregnancy (HDP) with those of normotensive mothers, to determine the incidence of perinatal stress using Apgar scores and to correlate hematocrit with Apgar scores in these newborn. STUDY DESIGN: This was a hospital-based comparative study conducted in the University of Port Harcourt Teaching Hospital, Nigeria. MAIN OUTCOME MEASURES: Apgar scores of 200 newborns- 100 from mothers with HDP (case group) and 100 from normotensive mothers (control group)- were taken at 1st and 5th minute of birth and cord blood samples collected to determine hematocrit. The subjects were categorized into polycythemic and non polycythemic using a hematocrit ≥65%. RESULTS: Eight percent of newborns of women with HDP had polycythemia while none of the controls did. Apgar scores in the case group with and without polycythemia at one-minute were 4.1±1.8 and 6.6±2.1, respectively and at 5 minutes were 6.9±1.7 and 8.5±1.4 respectively. Hematocrit correlated positively with Apgar scores (both at one and five minutes) in cases without polycythemia (r = 0.221, p = 0.034 and r = 0.255, p = 0.014). Hematocrit of polycythemic newborns did not correlate with Apgar scores (r = -0.287, p = 0.491 and r = -0.436, p = 0.281). CONCLUSION: The incidence of polycythemia is significantly higher in newborns of women with HDP and these polycythemic neonates had a significantly higher incidence of birth asphyxia. Therefore, birth outcome as determined by Apgar score is influenced by hematocrit.