Serum level of 25-hydroxyvitamin D and obesity among early pregnant women.

AIM: To assess serum 25-hydroxyvitamin D 25(OH)D level in obese pregnant Sudanese women in early pregnancy. METHODS: A match case-control study was conducted in Saad Abualila Hospital (Khartoum, Sudan). The cases were obese (body mass index [BMI] ≥ 30.0 kg/m2 ) women. Controls were women with normal BMI (18.5-24.9 kg/m2 ) matched for age, parity and gestational age. The 25(OH)D level was measured using ELISA. RESULTS: There was no significant difference between the two groups in their age, parity or gestational age. There was no significant difference in the median (interquartile) level of the serum (25(OH)D between obese pregnant women and normal weight pregnant women (3.05 [11.100-15.937] ng/ml vs 13.05 [10.950-17.362] ng/ml, P = 0.237). There was no significant correlation between BMI and 25(OH)D level (r = -0.133, P = 0.149). CONCLUSION: There was no significant difference in the 25(OH)D level between the obese pregnant women and normal weight pregnant women in this study.

Maternal and umbilical cord blood level of macrophage migration inhibitory factor and insulin like growth factor in Sudanese women with preeclampsia.

Preeclampsia is a health concern and it is the main cause of maternal and perinatal mortality. The macrophage migration inhibitory factor (MIF) and insulin-like growth factor-I (IGF-I) are factors associated with preeclampsia. A case-control (45 women in each arm) study was conducted at Saad Abualila Maternity Hospital (Khartoum, Sudan). The cases were of women who had preeclampsia, and the controls were healthy pregnant women. The clinical and obstetrical characteristics were gathered using a questionnaire and MIF and IGF-I levels were measured by ELISA. The cases and the controls (45 in each arm) were matched in their basic data. In comparison with the healthy controls, while the median (interquartile range) of the maternal MIF [8.221 (7.334-8.820) vs. 3.717 (2.385-4.883) ng/mL, p < .001] was significantly higher, the levels of the maternal IGF-1 [1.250 (0.670-1.980) vs. 1.939 (1.056-2.752), ng/mL, p < .001] were significantly lower in the women with preeclampsia. There was no significant difference in the cord levels of both the MIF and IGF-1 between the cases and controls. In linear regression, preeclampsia was the only factor that was significantly associated with the log of the maternal MIF (-0.338 ng/mL, p < .001), IGF-1 (0.293 ng/mL, p = .005) and cord MIF (-0.340 ng/mL, p < .001) levels. Impact statement What is already known on this subject? Macrophage migration inhibitory factor (MIF) has a pivotal role in pro-inflammatory processes during pregnancy/labour and its levels have been correlated with preeclampsia. Insulin like factors are produced in the liver under the stimulation of the growth hormones; they stimulate cell differentiation proliferations. IGF-I may be implicated in the pathogenesis of the adverse effects of preeclampsia (mainly the birth weight). What do the results of this study add? The current study showed a significantly higher level of MIF and lower level IGF-1 in the women with preeclampsia. Thus, both MIF and IGF-1 might have a role in the pathogeneses of preeclampsia. What are the implications of these findings for clinical practice and/or further research? MIF and IGF might be used as reliable markers to detect preeclampsia. These markers might be used as preventive or therapeutic elements for preeclampsia.

Hepatitis B infection and preeclampsia among pregnant Sudanese women.

BACKGROUND: Previous published studies have reported conflicting results of association between hepatitis B virus (HBV) infection and preeclampsia. There was no published data on HBV and preeclampsia in Africa including Sudan. The aim of the present study was to investigate the association between HBsAg seropositivity and preeclampsia. METHODS: A case -controls study (200 women in each arm) was conducted at Saad Abualila Maternity Hospital, Khartoum, Sudan. The cases were women with preeclampsia and the controls were healthy pregnant women. Socio-demographic characteristics were gathered using questionnaire and HBsAg was investigated using an ELISA. RESULTS: There was no significant difference between the cases and the controls in their age, parity, residence, education and blood groups. The majority of the cases were mild preeclampsia (159; 79.5%). In comparison with the controls, a significantly higher number of the cases were HBsAg seropositive [30 (15.0%) vs.12 (6.0%), P = 0.005]. In binary regression women with HBsAg seropositive were at higher risk of preeclampsia than women who were HBsAg seronegative (OR = 2.86, 95%, CI = 1.41-5.79, P = 0.003). CONCLUSION: In the current study HBsAg seropositivity is associated with preeclampsia. Preventive measure should be implemented.

Rubella, herpes simplex virus type 2 and preeclampsia.

BACKGROUND: Preeclampsia is a major health problem. Although, the pathophysiology of preeclampsia is not fully understood, there are recent studies on association between infections and preeclampsia. OBJECTIVE: The aim of the present study was to investigate the association between maternal seropositivity of rubella, Herpes simplex virus type 2 (HSV-2) and preeclampsia. METHOD: A case -controls study (90 women in each arm) was conducted at Saad Abualila Maternity Hospital, Khartoum, Sudan. The cases were women with preeclampsia and the controls were healthy pregnant women. Rubella and HSV-2 IgG antibodies were analysed in the maternal sera of all of the participants using ELISA. RESULTS: There was no significant difference in the age, parity and gestational age between the two groups. Maternal serum IgG seropositivity for rubella (92.2% vs. 34.4%, P < 0.001) and HSV-2 (87.8% vs. 57.8%, P < 0.001) were significantly higher in preeclampsia than in the controls. There was no significant difference in the maternal serum IgM seropositivity for rubella (3.3% vs. 2.2%, P = 0.650) and HSV-2 (2.2% vs. 1.1%, P = 0.560). All the IgM seropositive cases were IgG seropositive too. In binary logistic regression women with rubella (OR = 4.93; 95% CI = 2.082-11.692, P < 0.001) and HSV-2 (OR = 5.54; 95% CI = 2.48-12.38, P < 0.001) IgG seropositivity were at higher risk for preeclampsia. CONCLUSION: In the current study rubella and HSV-2 IgG seropositivity is associated with preeclampsia. Preventive measure should be implemented.

Prevalence of and risk factors for periodontal disease among pregnant women in an antenatal care clinic in Khartoum, Sudan.

OBJECTIVES: The aim was to investigate the prevalence of and factors associated with periodontal disease among pregnant Sudanese women. A cross-sectional study was conducted at the Antenatal Care Clinic of Saad Abualila Hospital (Khartoum, Sudan) from August to October 2018. Socioeconomic-demographic information and reproductive history were gathered using a questionnaire. Body mass index was computed from the weight and height. The diagnosis of periodontal disease was performed using criterion that also evaluated bleeding upon probing. RESULTS: Four hundred and four women were enrolled in the study, with a mean (SD) gestational age of 30.0 (8.7) weeks. Their mean (SD) age and parity were 27.0 (5.7) years and 1.6 (1.7), respectively. Ninety-seven (24.0%) of these 404 women had periodontal disease, which was mild, moderate and severe in 49 (12.1%), 36 (8.9%) and 12 (3.0%) women respectively, while 307 (76.0%) women had no periodontal disease. In logistic regression, age, parity, education, and brushing were not associated with periodontitis, but lower gestational age was associated with periodontal disease (OR = 0.96, 95% CI 0.94-0.99, P = 0.011).

Ovarian Cancer: Tumor-Specific Urinary Micro-Peptides Profiling as Potential Biomarkers for Early Diagnosis.

Ovarian cancer is the second major lethal gynecologic malignancy in developing countries. This study aimed to characterize urinary micro-peptides as potential diagnostic biomarkers for ovarian cancer. In a prospective, longitudinal and case-controlled study and following informed consent, urine and plasma samples were collected from 112 women with histologically-proven ovarian cancer and 200 apparently healthy age-matched volunteers. Urinary micro-peptides were detected and sequenced using SDS-PAGE and Edman degradation technique. Serum CA125 was detected in less than a quarter (23.2%, 26/112) of patients. One or more urinary micro-peptides were detected in about two thirds of the patients (62.5%, 70/112). A total of 40 patients had three bands (57.1%, 40/70), while two bands (15 and 35 kDa) were detected in 28.6% (20/70) of the patients. Isolated 45 kDa band was seen in 14.3% (10/70). No urinary micro-peptide was detected in the volunteers. The 15 and 35 kDa bands disappeared after 6 months of regular chemotherapy, while the 45 kDa band persisted in 2.9% (2/70) of the patients after treatment. The micro-peptides were identified as: Catalase (45 kDa), α-1 Acid Glycoprotein (35 kDa) and Peroxiredoxin-2 (15 kDa). Urinary catalase, α-1 Acid Glycoprotein and Peroxiredoxin-2 can be useful biomarkers for early detection and treatment response of ovarian cancer.

Toxoplasma gondii infection and pre-eclampsia among Sudanese women.

Background: Pre-eclampsia is the main cause of maternal and perinatal adverse effects. Although the exact mechanism and pathophysiology of pre-eclampsia are not yet fully understood, there are recent studies on the association between various infections and pre-eclampsia. This study investigated the association between maternal Toxoplasma gondii infection and pre-eclampsia. Methods: A case-control study was conducted at Saad Abualila Hospital, Khartoum, Sudan. The cases were pregnant women with pre-eclampsia and the controls were healthy pregnant women. Their obstetrics history was collected using a questionnaire. T. gondii antibodies (immunoglobulin G [IgG] and IgM) were analysed in the maternal serum of both the cases and the controls using enzyme-linked immunosorbent assay. Results: Maternal age and parity were not different between the cases and controls (90 women in each arm). There was a significant difference in the maternal anti-T. gondii IgG seropositivity, which was higher in the cases (pre-eclampsia) compared with the controls (32.3% vs 4.4%; p<0.001). There was no significant difference in the IgM seropositivity for T. gondii between the cases and controls (3.3% vs 1.1%; p=0.621). Binary logistic regression showed that women with toxoplasma IgG seropositivity were at higher risk for pre-eclampsia (odds ratio 9.40 [95% confidence interval 3.01 to 29.32]; p<0.001). Conclusions: In the current study, T. gondii infection seems to be associated with pre-eclampsia. Further research is needed.

Thyroid Function and 25 (OH) Vitamin D Level among Sudanese Women in Early Pregnancy.

AIM: A cross-sectional study was conducted at Saad Abualila Hospital (Khartoum, Sudan) to evaluate the vitamin D levels and thyroid function among pregnant Sudanese women (132) in early pregnancy. METHODS: A cross-sectional study was conducted at Saad Abualila hospital (Khartoum, Sudan) during the period from March to July 2015. Women who were in early pregnancy with a singleton pregnancy were approached to participate in the study after signing informed consent. A sample size of 132 participants was calculated guided by the normal interval of thyroid function in Sudanese women in the first trimester and not the level of 25(OH) vitamin D. The 25 - hydroxyvitamin D (25 (OH) vitamins levels were measured using an electrochemiluminescence immunoassay on an Elecsys 2010 Analyzer (Roche Diagnostics, Mannheim, Germany). RESULTS: The mean (SD) of age, gravidity and gestational age was 27.6 (5.5) years, 2.2 (1.6) and 10.4 (2.2) weeks, respectively. The mean (SD) of the body mass index (BMI) and haemoglobin was 27.1 (5.2) kg/m2 and 10.8 (1.1) g/dl, respectively. Median (interquartile) values of TSH, FT3, and FT4 were 1.164 IU/ml (0.079 -2.177 IU/ml), 4.639 nmol/l (3.843 - 6.562 nmol/l), and 16.86 pmol/l (13.02 - 31.48 pmol/l), respectively. There was no significant correlation between vitamin D levels and TSH, FT3 and FT4. CONCLUSION: There is no correlation between 25 (OH) vitamin D levels and thyroid function during early pregnancy among Sudanese pregnant women, despite prevalent vitamin D deficiency among these women.

Folic acid level and preterm birth among Sudanese women.

BACKGROUND: Preterm birth (PTB) is the major health problem world-wide; there are few published studies on PTB and folic acid. METHODS: The study was conducted to assess the serum level of folic acid in PTB. A case-control study was conducted at Saad Abualila maternity hospital (Khartoum, Sudan) during the period of March through December 2015. Women who delivered live singleton babies were dived in two groups; the cases were women who had PTB "delivery before completed 37weeks but after 24 weeks of pregnancy" and the controls were women who delivered at term (37-42 weeks). Medical and obstetrics history was gathered using questionnaire. Serum folic acid was measured. RESULTS: One hundred and twelve (56 in arm of the study) women were enrolled to the study. There was no significant difference between the cases and the controls in their age, parity, hemoglobin, body mass index, education and occupation. The median (interquartile) level of folic acid was significantly lower in the cases (PTB) than the level in the controls, 4.8(2.8-8.2) vs. 9.5(8.6-12.0) ng/ml. In binary regression, folic acid level was associated with lower risk of PTB (OR=0.64; 95%=0.53-0.77, P < 0.001). There was a significant positive correlation between gestational age and folic acid level (r = 0.447, P<0.001). CONCLUSION: Thus serum folic acid level was significantly lower in women with PTB. Folic acid level was associated with lower risk of PTB.

Low birth weight, preterm birth and short interpregnancy interval in Sudan.

OBJECTIVE: To investigate whether short interpregnancy interval (IPI) is associated with increased risk of low birth weight and preterm labour. METHODS: The study was conducted in the labour ward of Khartoum hospital in Sudan during November 2007 through February 2008. Odds ratios (ORs) were adjusted for the confounding factors using multiple logistic regression models. RESULTS: Compared with IPI of 18-30 months, those women with intervals shorter than 18 months had an increased risk of low birth weight (OR = 1.9, 95% CI = 1.0-3.5, P = 0.04) and preterm labour (OR = 2.3, 95% CI = 1.1-4.7, P = 0.01). CONCLUSION: In this study, IPI shorter than 18 months are independently associated with increased risk of adverse perinatal outcomes.

Knowledge and attitude toward HIV voluntary counseling and testing services among pregnant women attending an antenatal clinic in Sudan.

Human immunodeficiency virus (HIV) infection and the development of the acquired immunodeficiency syndrome (AIDS) are increasing at an alarming rate especially in the sub-Saharan region. Pregnant women susceptible to HIV and its transmission to the fetus provide a unique opportunity for implementing preventive strategy against HIV infection of newborn babies. During the period of August-December 2005 a cross-sectional study was conducted at the Fath-Elrahman Elbashir antenatal clinic, Khartoum Teaching Hospital, to investigate pregnant women's basic knowledge and attitude toward HIV and mother to child transmission as well as voluntary counseling and testing. Pre-tested structured questionnaires were given to antenatal attendants by professional counselors. Their basic socio-demographic and obstetric characteristics were obtained. Respondents' knowledge about HIV and mother to child transmission were tested. In addition, their willingness toward HIV testing was also reported. Out of the 1,005 women investigated, 79% had basic knowledge about HIV. Those who were resident in Khartoum and whose age was > or =26.1 years and their education level was secondary and above were found to be more knowledgeable about HIV. More than half of respondents were aware of mother to child transmission. Older (> or =26.1 years), educated, and working mothers were found to be more knowledgeable about mother to child transmission. Willingness to undergo the test was demonstrated in 72.8% of respondents. However, only 30.3% had the test done. Older women, primigravidae, and Muslims have higher acceptance of voluntary counseling and testing. There is a need to extend the voluntary counseling and testing program in all antenatal clinics. In addition, there is a need to increase the level of education and raise health awareness about HIV and mother to child transmission.