Risk factors for preterm delivery in south western Nigeria.

This was a case-control study to determine the risk factors of preterm delivery among Nigerian women seen at Obafemi Awolowo University teaching hospital, Ile-Ife, Nigeria over a period of 9 months. All women delivering preterm were recruited into the study, with two consecutive term deliveries after each preterm delivery serving as controls. Information obtained from the women includes socio-demographic characteristics, past reproductive and present pregnancy history and outcome. Laboratory investigations were conducted as necessary. Bivariate analysis revealed 21 potential risk factors, however, following adjustment by multiple logistic regression only previous preterm delivery (OR 4.68, 2.24-6.31), previous second trimester spontaneous abortion (OR 4.48, 2.32-8.54), heavy and stressful occupation (OR 3.56, 1.05-6.45), premature rupture of fetal membrane (OR 3.46, 1.04-6.45), maternal medical disorders (OR 3.13, 1.56-5.16), body mass index at delivery of less than 23 (OR 3.01, 1.56-5.43), antepartum haemorrhage (OR 2.73, 1.18-6.34), maternal febrile illness (OR 2.84, 1.32-4.52), intrauterine growth retardation (OR 2.14, 0.98-2.34) and multiple pregnancy (OR 1.98, 1.02-2.68) remained as significant factors.

Prevalence of human immunodeficiency virus (HIV) antibody among apparently healthy pregnant women in Nigeria.

OBJECTIVE: To determine the prevalence of human immunodeficiency virus (HIV) in pregnancy in our community. METHOD: A prospective study on 250 pregnant women currently attending the antenatal clinic at the Lagos University Teaching Hospital was carried out in 1991. RESULT: Results obtained showed that of the 250 pregnant women screened only two (0.8%) were seropositive for HIV. This indicates the risk of vertical or materno-fetal HIV transmission in our community and underscores the need for urgency for prospective monitoring of infants born to HIV seropositive women. CONCLUSION: Although the prevalence rate of HIV seropositivity amongst the otherwise healthy Nigerian pregnant women is only 0.8%, we advocate universal screening of HIV during pregnancy.

A comparison of human immunodeficiency virus (HIV) seropositivity and hepatitis B surface antigenemia (HBs Ag) among the same group of apparently healthy pregnant women in Lagos, Nigeria: a preliminary report.

Two hundred and fifty apparently healthy pregnant women attending the Obstetrics and Gynecology Clinic of the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria were screened for a comparison of the prevalence of HIV seropositivity and hepatitis B surface antigenemia (HBs Ag) amongst them. The Karpas AIDS cell test for HIV seropositivity and Bioman Hepatitis test kits were used as described by the manufacturers. HIV seropositive cases were confirmed using the Western blot test. Results revealed that out of the 250 pregnant women screened, 2 (0.8%) and 11 (4.4%) were HIV-1 and HBs Ag seropositive, respectively. However, the same 2 pregnant women now constituting 2 (18.2%) of the 11 HBs Ag positive pregnant women were simultaneously HIV-1 seropositive. Antibody to HIV-2 was not recorded in all HIV seropositive cases. This is the first report on the simultaneous prevalence of HBs Ag and HIV seropositivity among apparently healthy pregnant women in Lagos, Nigeria.

PIP: 250 sperm from apparently healthy pregnant patients at the Obstetrics and Gynecology Clinic at Lagos University Teaching Hospital, Lagos, Nigeria, were tested for HIV-1 and HIV-2 and hepatitis B surface antigen (HBsAg). Sera were screened for HIV with the Karpas AIDS cell test using HIV-1 and HIV-2 isolated in Great Britain, and confirmed with the Karpas confirming test and the Western blot. Bioman Hepatek kits were used for hepatitis screening. 2 pregnant women (0.8%) tested positive for HIV-1 and none for HIV-2. 11 women (4.4%) had HBsAg in their serum, and among these, 2 were positive for both HBsAg and HIV-1. This is the first report of pregnant women with both HIV and hepatitis virus screens in Lagos.

Effect of repeated semen ejaculation on sperm quality.

The semen quality of 21 Medical students who produced sperm by masturbation has been assessed. The mean density of 21 samples examined on the first day was 64,4 millions per millilitre, while that on the third and fifth day of the study period were 52.2 and 50.7 millilitre respectively. This showed a statistically significant difference between the first and the third samples. Another statistically significant difference (P less than 0.5) was demonstrated in the semen volume of the first and third, and the third and fifth samples respectively. Significant differences were, however, not observed in the motility and morphology changes in the group samples. We therefore conclude that even though repeated semen ejaculations on alternate days do affect the density and volume of the semen, the most important overall effect is not such as to impair the potential fertility of the man who has normal initial sperm characteristics.

Antenatal iron supplementation in sickle cell disease.

Fourteen pregnant women with sickle cell disease (11 SS and 3 SC) were randomized into two groups to receive routine antenatal supplementation either with ferrous gluconate or with placebo tablets. Their hemoglobin levels and bone marrow iron content were determined prenatally and 6 weeks post partum. The fetal weights and the incidence of pain crisis in both groups were recorded. Using an iron content grading from 0 to 5, no marrow of any subject showed iron depletion. The placebo group showed an aggregate postnatal loss of 4 grades of iron repletion while the iron supplemented group showed an aggregate gain of 2 grades. There were no significant differences between the birth weight or the incidence of pain crises in both groups. We conclude that routine iron supplementation is not justified in pregnant women with sickle cell disease, as it would tend to increase already adequate or excessive iron body stores. We recommend that a clear need for iron should be established before iron supplementation is prescribed to them.

Endometrial carcinoma in Nigerians. A pathologic study.

Endometrial carcinoma is an uncommon disease in the Nigerian female and its ratio to carcinoma of the cervix could be as low as 1:40, compared with the about 1:2 ratio for the temperate climates. In the 10-year period under review (1973-1982), only 10 cases could be clearly established. Nine tumors were adenocarcinomas, with most of these exhibiting a papillary pattern, while the tenth case was an adenosquamous carcinoma. One of the papillary adenocarcinomas contained clear cells. Most lesions were Grade I or Grade II. The youngest patient was 42 years of age while the oldest patient was aged 78 years (mean age, 58.9 years). A more favorable grade and lesser degree of myometrial invasion characterized the neoplasms in the younger patients.

Serum ferritin values in Nigerian pregnant women.

Serum ferritin values have been studied in 28 indigenous Nigerian pregnant women during the second and third trimesters of pregnancy. The mean serum ferritin value in the second trimester is higher than that in the third trimester, however, the difference is not statistically significant. When our results are related to those of Fenton and co-workers in 1977 (Fenton V, Cavill I, Fisher J: Iron stores in pregnancy. Br J Haem 37: 145, 1977) it appears that serum ferritin decreases in early pregnancy and that this decrease is maintained through the second and third trimesters and towards term, irrespective of adequate iron supplementation. It also seems that the pre-pregnancy serum ferritin level is achieved 5-8 weeks post-delivery. Our results also underline the sensitivity of serum ferritin evaluation in pregnancy, and reinforce the concept that fetal requirement for iron occurs significantly during the later half of pregnancy.

Are changing semen parameters a universal phenomenon?

The semen characteristics of 100 fertile indigenous blacks were studied. The mean semen volume was 2.6 ml, sperm density 55 million/ml, motility 61% and well-formed sperm 71%. These figures are comparable to those of similar recent studies in Caucasians but differ significantly from earlier studies. Our data seem to support recent observations that there has been a decline in the sperm density of fertile males in the past 3 decades and that the earlier standards of sperm concentration may be too high for the present.