Prevalence of Perinatal Asphyxia Using Apgar Scores and Cord Blood pH and the Relationship between the Two Methods: A Study of FMC Umuahia.

BACKGROUND: Perinatal asphyxia contributes significantly to neonatal morbidity and mortality. It occurs worldwide, and the Apgar score is the most widely used method of diagnosis. Recently, umbilical cord arterial pH has been reported as the most objective way to assess fetal acidosis at birth as it predicts the adverse outcome of perinatal asphyxia. It is imperative to establish the concordance between these two diagnostic methods to reinforce the practicality of the Apgar score as the preferred diagnostic tool for perinatal asphyxia in developing nations, such as Nigeria. AIM: To determine the prevalence of perinatal asphyxia by using the Apgar score and arterial cord blood pH and the relationships between these methods at the Federal Medical Center (FMC), Umuahia. MATERIALS AND METHODS: This cross-sectional study enrolled 245-term newborns. Perinatal asphyxia was diagnosed using both Apgar scoring and arterial cord blood pH measurements. Data obtained were analyzed using SPSS version 20 and a P value < 0.05 was considered significant. RESULTS: Perinatal asphyxia was reported in 33.1% and 31.4% by using the Apgar score and arterial cord blood pH, respectively. There was a moderate agreement between the two methods for diagnosing perinatal asphyxia (κ = 0.44), and no statistically significant difference was observed in the prevalence of perinatal asphyxia between these methods (McNemar's χ2 = 0.27, P = 0.699). Furthermore, a strong positive correlation was observed between the Apgar score at 1 and 5 minutes of life and arterial cord blood pH (rs = 0.87, P ≤ 0.001 and rs = 0.80, P ≤ 0.001 respectively). CONCLUSION: The prevalence of perinatal asphyxia by the two methods was high, and there was no significant difference between both methods of assessing perinatal asphyxia. Thus, the diagnosis of perinatal asphyxia can effectively be made using either the Apgar score or arterial cord blood pH, affirming the practicality and reliability of the Apgar score in resource-limited healthcare settings.

Prevalence and predictors of postpartum depression among postnatal women in Lagos, Nigeria.

BACKGROUND: Globally, postpartum depression is one of the most common but often unrecognized complications of childbirth, yearly affecting about 10-15% of postnatal women. This study aimed to determine the prevalence of postpartum depression and its predictors among postnatal women in Lagos. METHODS: A descriptive cross-sectional study was conducted among 250 mothers in Eti-Osa Local Government Area of Lagos State, Nigeria, attending six Primary Health Care centers for infant immunization at six weeks post-delivery. Data was collected using a pretested semi-structured interviewer administered questionnaire which included the Edinburgh Postnatal Depression Scale. Analysis was carried out using SPSS version 23TM. Chi-square and logistic regression analyses were used to determine associations and predictive relationships between various factors and the presence of postpartum depression. The level of significance was set at <0.05. RESULTS: The prevalence of postpartum depression was 35.6%. Multiparity, delivery by cesarean section, mother being unwell after delivery, and not exclusively breastfeeding the baby were the factors linked with postpartum depression. Following multiple logistic regression, having postpartum blues (p=0.000; OR=32.77; 95%CI=7.23-148.58)., not getting help with caring for the baby (p=0.008; OR=2.64; 95%CI=1.29-5.42), experiencing intimate partner violence (p=0.000; OR=5.2; 95%CI=2.23-11.91) and having an unsupportive partner (p=0.018; OR=2.6; 95%CI=1.17-5.78) were identified as predictors of postpartum depression. CONCLUSION: This study revealed a high prevalence of postpartum depression, identifying both the obstetric and psychosocial predictors. Social support for women both in the pre- and postnatal periods and routine screening of women for postpartum depression should be encouraged for early detection and immediate intervention.

HIV/AIDS-Related Knowledge, Attitudes and Uptake of HIV Testing Services:A Comparative Study of Male and Female Secondary School Students in Lagos, Nigeria.

BACKGROUND: Knowledge of HIV/AIDS and use of HIV Testing Services in Nigeria is still far from optimal. Good HIV/AIDS-related knowledge and attitudes are important in prevention. The aim of this study was to assess and compare HIV/AIDS knowledge, attitudes and the uptake of HIV Testing Services between male and female senior secondary school students in Lagos, Nigeria. METHODS: Using multistage sampling, 543 (50.3% male, 49.7 % female) participants were selected in a comparative cross-sectional study carried out in six senior secondary schools in Alimosho LGA, Lagos. Data was collected using a pre-tested, self-administered questionnaire and analyzed using SPSS- 20, p<0.05 was considered significant. RESULTS: Participants' level of knowledge of HIV/AIDS was good (86.4% male, 86.3% female), the difference was not statistically significant. The main source of HIV/AIDS information was their teachers (male - 53.6%, female - 49.3%). Attitudes were positive (99.3% males, 98.1% females). However, the uptake of HIV testing was low (27.8% male, 24.1% female). Only 41.8% of males and 34.1% of females knew where HIV Testing Services were offered. The uptake of HIV testing showed a significant association, for the males, with family structure (p=0.034), confiding in their fathers (p=0.039) and religion (p=0.044), and for the females, mothers' level of education (p=0.036), number of siblings (p=0.044) and alcohol use (p=0.006). CONCLUSION: In both groups, knowledge and attitude were optimal, however. the uptake of HIV testing was low due to poor access. Teaching about HIV/AIDS in schools should be sustained, but to improve the use of HIV Testing Services, stronger families are encouraged, though providing more HIV testing centers, especially Youth Friendly Centers should be considered.