Maternal exposure to carbon monoxide in the first trimester (7-13+6 weeks) of pregnancy in the core Niger Delta

Background: Irrespective of the fact that the Niger Delta was known for its environmental pollution, neither organized environmental assessment nor human biomonitoring, including that of carbon monoxide (CO) had been performed in the region. The aim of the study therefore was to establish the severity of maternal impact on exposure to CO in the first trimester of pregnancy by quantifying the exhaled CO concentrations (ECOC) and to assess the effect of maternal age, body mass index (BMI) and parity on the severity of the impact.Methods: The study was of cross-sectional design carried out at the Rivers State University Teaching Hospital (RSUTH) in Rivers State. 490 consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Gestational age was estimated with the aid of ultrasound scan. Demographic, social and obstetric characteristics were taken. Exhaled carbon monoxide concentration (ECOC) was measured with the aid of a smokerlyzer. Data was analyzed, using the statistical package for social sciences (SPSS) version 25.0 (Armonk, NY) software. Ethical approval was obtained from the RSUTH ethics committee.Results: The mean value of ECOC 3.25±2.51 ppm was more than that obtained in other studies. Out of the total 490 patients that were assessed, 335 (68.37%) had mild impact from CO exposure (ECOC=1-3 ppm), 129 (26.33%) – moderate impact (ECOC=4-6 ppm) and 26 (5.31%) had severe impact (ECOC=more than 6 ppm). Moderate and severe impacts were more prominent in women of age groups 25-39 years and the differences in various age groups were statistically significant [X2=20.671, p<0.036, 95% CI (0.032, 0.040)]. Patients with higher BMI were more likely to have moderate and severe impact than those with lower BMI- 6 (33.33%) and 4 (22.22%) out of the 18 patients with class III obesity had moderate and severe impacts respectively. The differences in the impact at various BMI were statistically significant [X2=20.671, p<0.001, 95% CI (0.001, 0.002)]. There was inverse relationship between parity and the severity of the impact and the differences in various parity groups were statistically significant [X2=10.580, p<0.012, 95% CI (0.101, 0.113)]. There was also a paradoxical finding of 3 smokers having only mild impact.Conclusions: The mean value of ECOC 3.25±2.51 ppm was more than that obtained in other studies in non-pregnant women. Mild, moderate and severe impact from maternal CO exposure were established with the moderate and severe impact more prominent at maternal ages of 25-39 years, at higher BMI and at lower parity

Pattern of endocrine diseases in children at the University of Port Harcourt Teaching Hospital

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The Magpie Trial: A randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for women at 2 years

Objective: The aim of this study was to assess long-term effects for women following the use of magnesium sulphate for pre-eclampsia. Design: Assessment at 2-3 years after delivery for women recruited to the Magpie Trial (recruitment in 1998-2001, ISRCTN 86938761), which compared magnesium sulphate with placebo for pre-eclampsia. Setting: Follow up after discharge from hospital at 125 centres in 19 countries across five continents. Population: A total of 7927 women were randomised at the follow-up centres. Of these women, 2544 were not included for logistic reasons and 601 excluded (109 at a centre where <20% of women were contacted, 466 discharged without a surviving child and 26 opted out). Therefore, 4782 women were selected for follow-up, of whom 3375 (71%) were traced. Methods: Questionnaire assessment was administered largely by post or in a dedicated clinic. Interview assessment of selected women was performed. Main outcome measures: Death or serious morbidity potentially related to pre-eclampsia at follow up, other morbidity and use of health service resources. Results: Median time from delivery to follow up was 26 months (interquartile range 19-36). Fifty-eight of 1650 (3.5%) women allocated magnesium sulphate died or had serious morbidity potentially related to pre-eclampsia compared with 72 of 1725 (4.2%) women allocated placebo (relative risk 0.84, 95% CI 0.60-1.18). Conclusions: The reduction in the risk of eclampsia following prophylaxis with magnesium sulphate was not associated with an excess of death or disability for the women after 2 years. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.Articl

The Magpie Trial: A randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for children at 18 months

Objective: To assess the long-term effects of in utero exposure to magnesium sulphate for children whose mothers had pre-eclampsia. Design: Assessment at 18 months of age for children whose mothers were recruited to the Magpie Trial (recruitment 1998-2001 ISRCTN 86938761), which compared magnesium sulphate with placebo. Setting: Follow-up of children born at 125 centres in 19 countries across five continents. Population: A total of 6922 children were born to women randomised before delivery at follow-up centres. Of these, 2271 were not included for logistic reasons and 168 were excluded (101 at a centre where <20% were contacted, 40 whose death or disability was due to a problem at conception or embryogenesis and 27 whose parent/s opted out). Therefore, 4483 children were included in follow-up, of whom 3283 (73%) were contacted. Methods: Assessment by questionnaire, with interview and neurodevelopmental testing of selected children. Main outcome measures: Death or neurosensory disability at age of 18 months. Results: Of those allocated magnesium sulphate, 245/1635 (15.0%) were dead or had neurosensory disability at 18 months compared with 233/1648 (14.1%) allocated placebo (relative risk [RR] 1.06, 95% CI 0.90-1.25), and of survivors, 19/1409 (1.3%) had neurosensory disability at 18 months compared with 27/1442 (1.9%) (RR 0.72, 95% CI 0.40-1.29). There were no substantial differences in causes of death or in the risk of individual impairments or disabilities. Conclusions: The lower risk of eclampsia following prophylaxis with magnesium sulphate was not associated with a clear difference in the risk of death or disability for children at 18 months. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.Articl