RESUMO
Background: Antenatal depression (AD) is prevalent and associated with adverse pregnancy, maternal and child outcomes, yet no study has addressed its magnitude and predictors in early pregnancy in Nigeria. Aim: To determine the prevalence and factors associated with AD in first half of pregnancy. Setting: Multicentric health facilities in Southern Nigeria. Methods: A multicentric health-facilities-based cross-sectional study was conducted from January to July 2018. Using pretested structure interviewer-administered questionnaires, antenatal depressive symptoms were assessed amongst 511 pregnant mothers with the Edinburg Postnatal Depressive Scale tool. Socio-demographic, socio-economic, clinical, family and social factors were also measured. Descriptive statistics, bivariate and multivariable logistic regression analyses were employed to describe and identify factors associated with AD. Results: The prevalence of antenatal depressive symptoms in early pregnancy in this study was 29.4% (95% confidence interval [CI] 26.6-32.9). Factors independently associated with AD were intimate partner violence (adjusted odds ratios [AOR] = 8.10, 95% CI 5.00-13.14), marital dissatisfaction (AOR 5.48, 95% CI 3.48-8.38), poor social support (AOR 4.70; 95% CI 2.99-7.38), past history of depression (AOR 4.67; 95% CI 2.47-8.80), previous pregnancy complication (AOR 2.50, 95% CI 1.57-3.89), low socio-economic status (AOR 2.41, 95% CI 1.61-3.66) and unplanned pregnancy (AOR 2.35, 95% CI 1.47-3.64). Conclusions: The prevalence of antenatal depression is high with modifiable risk factors requiring context-specific policies such as provision of family, social and economic support for mothers at the earliest possible contact in the antenatal period.
RESUMO
AIM: To determine the levels of serum homocysteine and its association with insulin resistance among T2DM patients at Obafemi Awolowo University Teaching Hospital, Ile Ife Nigeria. METHODS: It was a cross sectional study. It involved consecutive recruitment of 100 T2DM subjects with 100 age and sex matched controls. The fasting plasma glucose, serum creatinine, fasting lipid profile, glycosylated haemoglobin levels, fasting serum insulin and plasma homocysteine concentration were done. Insulin resistance was also determined. SPSS version 17.0 was used for data analysis. RESULTS: The mean age of subjects was not significantly different from controls. (58.9±8.3 vs. 59.0±8.3years, p=0.926 respectively). Mean Homocysteine level (tHcy) was significantly higher among T2DM subjects compared to controls (27.4±12.1 and 8.3±3.2µmol/L respectively, p=0.0001). Hyperhomocystinaemia was commoner among diabetic subjects compared with controls (81% vs. 5%, p<0.0001). T2DM with hyperhomocystinaemia were more likely to have poorer glucose control profile using glycated haemoglobin (7.4±1.9 vs 6.4±1.4%, p=0.04) and fasting blood glucose 8.6±2.2 vs 7.5±2.4mmol/L p=0.047 and insulin resistance (4.4±4.3 vs. 2.0±0.6, p=0.02) compared with T2DM with normohomocystenaemia. There were significant associations between hyperhomocystinaemic T2DM patients and IR, HbA1c, TC, TG and LDL cholesterol. CONCLUSION: The study showed higher homocysteine levels in T2DM than controls. Homocysteine level is worsened by increasing insulin resistance, dyslipidaemia and poor glucose control. Homocysteine level is a potential cardiovascular risk marker in type 2 diabetic mellitus subjects.