Factors Influencing Antenatal Haematinics Prescription Behaviour of Physicians in Calabar, Nigeria

BACKGROUND: Routine iron and folic acid supplementation in pregnancy have been proved to be effective in reducing the prevalence and morbidities of anaemia. However, there is limited data regarding the prescription habits of physician obstetric care givers.AIM: This study set to investigate the attitudes and factors which influence the practice among physicians in University of Calabar Teaching Hospital (UCTH).MATERIAL AND METHODS: A questionnaire based cross-sectional survey was conducted among randomly recruited physician offering antenatal services between August and September 2015. Systemic sampling was used to select 70 doctors in the departmental duty roster. Data were presented in percentages and proportion. Chi-square test was used to test the association between variables. Statistical significance was set at p < 0.05.RESULTS: The response rate was 100%. The mean age of the respondents was 30.26 ± 6.67 years. All the respondents routinely prescribed haematinics to pregnant women but 34.3% of them did not prescribe to apparently healthy clients in their first trimester. Only 30% and 11.4% of them prescribed it in the postnatal and preconception periods respectively. Brands that contained iron, folate and vitamins as a single capsule were mostly favoured, and information about brands of drugs was mostly provided by the pharmaceutical sales representatives. Younger doctors were more likely to offer haematinics with nutritional counselling compared to older respondents. However, there was no significant relationship between haematinics prescription and sex (p = 0.3560), Age (p = 0.839), current professional status (p = 0.783), and client complaint of side effect of medication (p = 0.23). Oral medication was mostly utilised.CONCLUSION: Effort to effectively control anaemia in pregnancy should involve re-orientation of physician obstetric care providers especially about prenatal and postnatal medication and counselling

Antenatal Deworming and Materno-Perinatal Outcomes in Calabar, Nigeria

BACKGROUND: Studies have shown that administration of anthelmintic drugs in pregnancy can reduce the incidence of maternal anaemia; however, data on other maternal and perinatal outcomes are limited.AIM: This study was therefore conducted to evaluate the direct impact of mass deworming on delivery and perinatal outcome.MATERIAL AND METHODS: A total of 560 healthy pregnant women in their second trimester were randomised to receive a single dose of oral mebendazole (500 mg) and placebo. Each participant received the standard dose of iron supplement and malaria prophylaxis. They were followed up to delivery and immediate postpartum period to document the possible impact on maternal and perinatal outcomes.RESULTS: The prevalence of anaemia at term, 37 weeks gestation and above, among the treatment arm was 12.6% compared with 29.9% in the placebo arm (p < 0.001). Caesarean section rates was higher in the treated group and the placebo (p = 0.047).There were no statistically significant differences in incidences of postpartum haemorrhage (p = 0.119), Puerperal, pyrexia (p = 0.943), low birth weight (p = 0.556) asphyxia (p = 0.706) and perinatal death (p = 0.621).CONCLUSION: Presumptive deworming during the antenatal period can significantly reduce the incidence of peripartum anaemia. However, more studies may be needed to prove any positive perinatal outcome

Severe Life-Threatening Pregnancy Complications, “Near Miss” and Maternal Mortality in a Tertiary Hospital in Southern Nigeria: A Retrospective Study

Background. Investigating severe life-threatening pregnancy complications that women encounter and the maternal morbidities (near miss) may help to evaluate the quality of care in health facility and recommend ways to improve maternal and infant survival especially in low-income countries. The aim of this review was to identify, classify, and determine the frequency and nature of maternal near miss events and the maternal and perinatal outcomes. Methods. A retrospective facility-based review of cases of near miss and maternal mortality occurring between 1st January 2012 and 31st December 2016 at the University of Calabar Teaching Hospital was conducted. Near miss case definition was based on the WHO disease specific criteria. The main outcomes included the maternal mortality ratio (MMR), maternal near miss ratio (MNMR), mortality index, maternal morbidities, and perinatal outcome. Results. There were 10,111 pregnancy-related admissions, 790 life-threatening pregnancy complications that resulted in 99 maternal deaths, and 691 near miss cases. The maternal mortality ratio was 979 maternal deaths per 100,000 live births, and the maternal near miss ratio was 6,834 per 100,000 maternities. The MMR to MNMR ratio was 1 : 8. Sepsis and severe anaemia had high case-specific mortality indices of 0.4 and 0.53, respectively. The perinatal outcome was poor compared to that of uncomplicated pregnancies: perinatal mortality rate (PMR) 266 per 1000 live births (OR 7.74); neonatal intensive care (NIC) admissions 11.6 percent (OR 1.83); and low birth weight (LBW) (<2.5 kg) 12.19 percent (OR 1.89). Conclusion. Antenatal care and early recognition of danger signs in pregnancy as well as prompt referral and early institution of essential obstetrics care are important for maternal and infant survival

The Prevalence, Pattern, and Predictors of Sleep Disorders Among Pregnant Women Attending Antenatal Clinic in a Southern Nigerian City

Background: Sleep disorders are a common and often undiagnosed chronic health problem associated with an increased incidence of metabolic syndrome and pregnancy complications. Aim: The purpose of this study was to find out how common sleep disturbances are among pregnant women in Calabar, as well as their patterns and risk factors. Materials and Methods: A cross-sectional study was conducted among 360 antenatal attendees in the three major public health facilities in Calabar and 338 completed questionnaires were included in the analysis. Socio-demographic, medical, and obstetrics information were obtained using interviewer-administered questionnaires. Major international sleep classification tools were used to identify the patterns of sleep disturbance. Their weights and heights as well as their blood pressures (BPs) were measured. Data were analyzed using SPSS version 23. The predicting factors were extracted using a logistic regression model. Results: The prevalence of sleep disorder was 44.1%. The most common pattern of sleep disorder was insomnia (34.6%). Nineteen (5.6%) of them reported mixed disorders. On logistic analysis, pregnant women with normal BP (odds ratio [OR]: 0.440, 95% confidence interval [CI]: 0.230–0.843, P = 0.013), normal body mass index (OR: 0.365, 95% CI: 0.133–1.001, P = 0.050) and maternal age 20–30 years, (OR: 0.169, 95% CI: 0.30–0.969, P = 0.046) were significantly less likely to suffer from sleep disorders. Residing in a single a room apartment with family members was an independent social determinant of sleep deprivation (OR: 2.009, 95% CI: 1.003–4.025, P = 0.049). Conclusion: The study suggested that the prevalence of sleep disturbance is high among pregnant women. Counseling on good quality sleep during pregnancy may improve pregnancy outcome by ensuring appropriate weight gain and good BP control