Comparing neonatal outcomes in women with preeclampsia and those with normal pregnancy

Background: Preeclampsia has remained an important public health problem in the developing world where it is associated with a five-fold increase in perinatal morbidity and mortality. Objective: We set out to compare neonatal outcomes between women with preeclampsia and those with normal pregnancy. We also sought to evaluate factors associated with poor outcome in the neonates. Materials and Methods: This was a prospective cohort study that enrolled 90 women (45 with preeclampsia and 45 with normal pregnancy) after 20 weeks gestation. Maternal socio-demographic and clinical information was obtained at enrolment and delivery using questionnaire. Neonatalanthropometric and physiologic data was obtained at delivery and used for classifying the birth weight according to the WHO classification. APGAR score was used to evaluate the presence of birth asphyxia. We defined poor outcome as the presence of at least one of low birth weight,  prematurity, birth asphyxia and need for admission. SPSS version 25 was used in all analysis. Significance testing was set at p=0.05. Results: The women with preeclampsia were significantly heavier at booking (BMI 29.0±6.9 Kg/ m2 vs 25.0±5.2. p=0.005), have higher mean booking systolic blood pressure (122.±22.6 mmHg vs 111.5±12.7mmHg, p=0.003) and diastolic blood pressure ( 7 9 . 8 ± 1 4 . 3mm Hgvs 68.8±9.0mmHg, p<0.001). Neonates of women with preeclampsia were significantly more premature ( meangestational age = 36 . 8 ± 3 . 2 week svs 38.7±2.0weeks, p=0.001) and lighter (mean birth weight =2,529±817.5g vs 3,079.2±527.4g, p<0.001). Overall, 22 (49.4%) of the neonates of women with preeclampsiahad significantly poor outcome compared with 12(27.4%) of the neonates of women with normal pregnancy (p=0.01). Univariate logistic analysis showed only being a male neonate, maternal preeclampsia and admission in index pregnancy were significantly associated with poor outcome.  Multivariable logistic regression showed only being a male neonate to be 3 times more likely to have a poor outcome (Wald=5.34. OR=3.2, p=0.02) Conclusions: Intrauterine exposure to preeclampsia is associated with poor neonatal outcomes especially in males Key words: infant outcome, preeclampsia, Nigeri

Bilan des politiques et des programmes destinés à la promotion de la santé maternelle dans l'état de Plateau au Nigéria.

Plateau state, one of Nigeria's 36 federating states, currently has a high rate of maternal mortality in the country. This study was designed to determine the nature of policies and programs for maternal health in the State with a view to identifying strategic interventions for reducing the high rate of maternal mortality in the state. Plateau state places high priority on the provision of qualitative healthcare for the citizens, but is yet to legislate on, and develop strategic policies and plans for maternal health. Human resource for health is grossly inadequate and available data on healthcare funding and logistics are not satisfactory. The healthcare infrastructure is also inadequate, while there is a need to improve the provision of a fully functional health system, logistics and resources for health. We believe that intense advocacy is needed to increase political will to improve maternal health and to reduce the high rate of maternal morbidity and mortality in Plateau StateL'état de Plateau, un des états fédéraux du Nigéria a actuellement un taux élevé de mortalité maternelle dans le pays. Cette étude a été conçue pour déterminer la nature des politiques et des programmes de la santé maternelle dans l'état en vue d'identifier les interventions stratégiques destinées à la réduction du taux élevé de mortalité maternelle. L'état de Plateau accorde une haute priorité à l'assurance des services médicaux qualitatifs à ses citoyens, mais il n'a pas encore légiféré sur la santé maternelle. Il n'a pas non plus élaboré des politiques stratégiques et des plans pour la santé maternelle. Les ressources humaines pour la santé sont largement inadéquates et les données dont on dispose sur le financement de soins médicaux et sur la logistique ne sont pas satisfaisantes. L'infrastructure de soins médicaux est également inadéquate, tandis qu'il y a la nécessité d'améliorer l'assurance d'un système de santé qui fonctionne bien, ainsi que la logistique et les ressources pour la santé. Nous sommes convaincus qu'un plaidoyer intensif est nécessaire pour augmenter la volonté politique pour améliorer la santé maternelle et pour réduire le taux élevé de morbidité et mortalité maternelles dans l'état de Platea