Nutritional factors associated with anaemia in pregnant women in northern Nigeria.

This study was conducted to assess the relative contribution of iron, folate, and B 12 deficiency to anaemia in pregnant women in sub-Saharan Africa. In total, 146 pregnant women, who attended two antenatal clinics in Gombe, Nigeria, were recruited into the study. The majority (54%) of the women were in the third trimester. Blood samples were obtained for determination of haematocrit and for measurement of serum iron, total iron-binding capacity, ferritin, folate, vitamin B12, and homocysteine. Malaria was present in 15 (9.4%) women. Based on a haemoglobin value of<105 g/L, 44 (30%) women were classified as anaemic. The major contributing factor to anaemia was iron deficiency based on the serum concentration of ferritin (<10 ng/mL). The mean homocysteine concentration for all subjects was 14.1 pmol/L, and homocysteine concentrations were inversely correlated with concentrations of folate and vitamin B 12. The serum homocysteine increased markedly at serum vitamin B12 levels below 250 pmol/L. The most common cause of anaemia in the pregnant women in northern Nigeria was iron deficiency, and the elevated concentrations of homocysteine were most likely due to both their marginal folate and vitamin B12 status.

Plasma and urinary free amino acid concentrations in preeclamptic women in northern Nigeria.

BACKGROUND: Preeclampsia/eclampsia is one of the major causes of maternal and fetal mortality in Nigeria and many other countries in sub-Saharan Africa. We determined if serum and urine concentrations of amino acids were abnormal in women with this disorder of pregnancy in Gombe, Nigeria. METHODS: Free amino acids were measured in serum and urine of women (ages, 15 to 40 years) with preeclampsia/eclampsia (n=37) and their pregnant age and gestational age matched controls (n=16). RESULTS: The concentrations of 19 of the 20 serum amino acids that are common in proteins were not significantly different between the control and preeclamptic groups. Phenylalanine was increased in the preeclamptic women compared to the controls (p<0.05); however, the difference between the two values was small (119 vs. 104 umol/l, respectively). The concentrations of urine free amino acids were indexed to urine creatinine (i.e., nmol/mg creatinine). Five amino acids were significantly elevated in the urine of preeclamptic patients vs. the control group: proline (100%, p<0.05), the branched amino acids, valine (80%, p<0.05), leucine (61%, p<0.05), isoleucine (49%, p=0.01), and methionine (52%, p<0.005). On the other hand, the concentrations of a nutritionally non-essential amino acid, glycine (p=0.01), and an essential amino acid, histidine (p=0.01), were both reduced by about one-third in the urine of the preeclamptic women. CONCLUSIONS: Our findings indicate that there are disturbances in urinary amino acid excretion but not in the serum amino acid profile in the preeclamptic patients. The degree of aminoaciduria is probably not sufficient to significantly affect overall nitrogen balance or precipitate a deficiency of one or more of the essential amino acids.

High-density lipoprotein and homocysteine levels correlate inversely in preeclamptic women in northern Nigeria.

BACKGROUND: Preeclampsia/eclampsia is one of the most common complications of pregnancy. It is a cause of high morbidity for both mother and fetus, especially in developing countries. In a recent survey conducted in Gombe, Nigeria, eclampsia was found to be a major cause of maternal mortality (24.2%), second only to obstetric hemorrhage (27.1%). Previous studies have produced contradictory findings regarding total homocysteine (tHcy) levels in women with preeclampsia/eclampsia and there is little information about the relationship between particular serum lipids and tHcy. The objective of this study in Gombe was to compare the levels of serum lipids and homocysteine in healthy pregnant women and women with preeclampsia/eclampsia in Nigeria. METHODS: The experimental subjects included 43 women with preeclampsia/eclampsia and 130 healthy pregnant women served as controls. The criteria for preeclampsia/eclampsia included the following: hypertension (blood pressure > 140/90 mmHg), total protein (> 190 mg/g creatinine), and edema. Blood sera obtained from patients and controls attending the prenatal clinics at the Specialist Hospital and the Federal Medical Center in Gombe were analyzed for tHcy, total cholesterol, triglycerides, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, antioxidant capacity, folate, and vitamin B-12. RESULTS: The mean tHcy concentration for the preeclamptic/eclamptic women was greater than that of the controls (10.1 vs. 8.4 micromol/l, respectively, p = 0.01). The mean concentrations of LDL-cholesterol and triacylglycerols were not different between the two groups. However, the mean HDL-cholesterol level was higher in the healthy pregnant women compared with the preeclamptic/eclamptic women (1.64 vs. 1.42 mmol/l, respectively, p = 0.02). The HDL-cholesterol concentration was correlated inversely with the tHcy concentration (p = 0.001, r = 0.51). Total homocysteine was not linked with either serum folate or vitamin B-12. CONCLUSIONS: These results show that preeclampsia/eclampsia is associated with increased tHcy levels and that HDL levels are depressed in Nigerian women with this hypertensive, pregnancy associated disorder.