Comparison of Pregnancy Outcome Between Teenage and Older Primigravidae in Jos University Teaching Hospital, Jos, North-Central Nigeria

Background: Teenage pregnancy constitutes a major health and social problem the world over. The objectives of the study were to determine the incidence of teenage pregnancy and to compare the socio-demographic characteristics, booking/delivery ratio and pregnancy outcomes of teenagers and the control in Jos University Teaching Hospital. Method: A prospective case-controlled study of the pregnancy outcome in 128 booked teenage primigravidae was compared with 633 older primigravidae aged 20-34 years (control group); who booked for antenatal care between January and December 2003 in Jos University Teaching Hospital (JUTH), Jos was conducted. Result: The study showed teenage mothers to have significantly increased proportions of Hausa/Fulani ethnicity (p=0.0000), Muslim religion (p=0.0000), lower educational status (p=0.0000), lower income group (p<0.05), low birth weight babies (p = 0.031) and more likely to deliver outside of JUTH after booking (p = 0.036) compared to the control. There were no significant differences in the proportions of marital status (p = 0.06), first trimester booking (p = 0.68), preterm labour (p = 0.55), obstetric complications (p>0.05), obstetric interventions (p = 0.78), birth asphyxia (p = 1.00) and crude perinatal death rate (p = 0.21) compared to the control. Conclusion: This study has demonstrated that teenage pregnancy even though it predisposes to complications of pregnancy and labour, but when teenagers receive good antenatal care, pregnancy and labour outcome is comparable to that of other age groups.Introduction : La grossesse chez des jeunes constitue un risque grave pour la sant\ue9 et un probl\ue8me social dans le monde entier. Les objets de cette \ue9tude \ue9taient de d\ue9cider la fr\ue9quence de la grossesse des jeunes et de faire une comparaison des traits caract\ue9ristiques socio-d\ue9mographique, proportion d'inscription/accouchement avec des r\ue9sultats de la grossesse chez les jeunes et le contr\uf4le au centre h\uf4pitalier universitaire de Jos. M \ue9thodes : Une \ue9tude en perspective d'un cas contr\uf4l\ue9 du r\ue9sultat de la grossesse chez 128 jeunes primigravidae inscris a \ue9t\ue9 compar\ue9 avec 633 primigravidae plus \ue2g\ue9es, \ue2g\ue9e de 20 \u2013 34 (groupe t\ue9moin), qui se sont inscris pour des soins ant\ue9natals entre janvier et d\ue9cembre 2003 au centre h\uf4pitalier universitaire de Jos (CHUJ) \ue9tait effectu\ue9. R\ue9sultats : L'\ue9tude a montr\ue9 des jeunes m\ue8res avec des proportions \ue9lev\ue9es d'ethnicit\ue9 Haussa/Fulani (P=0,0000), statut d'enseignment inf\ue9rieur) P=0,0000) tranche de salaire inf\ue9rieure (P=0,05), b\ue9b\ue9 avec poids de naissance inf\ue9rieure (P=0,031) et plus probablement d'accoucher \ue0 l'ext\ue9rieur du CHUJ apr\ue8s l'inscription (P=0,036) par rapport au groupe t\ue9moin. Il n'y avait pas d'\ue9cart important dans la proportion de la situation de famille (P=0,06) inscription trimestre premier (P=0,68), accouchement avant terme (P=0,55) complications obst\ue9triques (P>0,05) interventions obst\ue9triques (P=0,78) asphyxie de natalit\ue9 (P=1,00) et taux de mortalit\ue9 grossi\ue8re p\ue9rinatale (P=0,21) par rapport au groupe t\ue9moin. Conclusion : A travers cette \ue9tude on peut conclure que grossesse des jeunes bien q'elle pr\ue9dispose aux complications de la grossesse et d'accouchement, mais quand des jeunes recevoient un tr\ue8s bon soins ant\ue9natals, le r\ue9sultat de la grossesse et d'accouchement est semblable \ue0 ceux d'autre tranche d'\ue2ge

Postmaturity and Fetal Macrosomia in Jos, Nigeria

Background: One of the risk factors of post term pregnancy is fetal macrosomia. The excessively large infant presents a recurring and potentially serious obstetric problem. Methods:This was a retrospective study of all consecutive births in the maternity unit, Jos University Teaching Hospital, Jos, Nigeria, between January 1998 and December 2001. The case records of all mothers of babies born with weight of 4000g and above were retrieved and data collated and analyzed for total deliveries, maternal and fetal characteristics, complications and outcome of pregnancy. Results:Macrosomic infants (4000g and above) were 286 cases representing 2.9% of all deliveries. Ten (3.5%) of the infants with macrosomia were preterm, 90.9% were term, and 5.6% were post-term. The mean age and parity of the mothers with pregnancies at term was 29.2 years, and 3.2 respectively. The post term mothers had a mean age and parity of 32.7 years and 3.8 respectively. Maternal morbidity included increased caesarean delivery, and vaginal trauma (episiotomies, tears and bruises) in both groups. Caesarean section was the mode of delivery in 31.3% of post term and 27.6% term infants, while the indication for caesarean section was cephalopelvic disproportion in 80% and 87.3% for post term and term infants respectively. Fetal complications were birth asphyxia and stillbirth. There were no gross fetal abnormalities recorded in the series. Still birth rate was 8.1% and 12.5% in term and post term infants respectively. Conclusion: Post term pregnancies account for macrosomic babies in our facility, posing an increased risk to the mother and fetus. Early diagnosis, intrapartum fetal monitoring and recourse to operative delivery may improve the fetal outcome of these infants. A correction to this article has been issued in Annals of African Medicine, Vol. 4, No. 3, 2005, pp. 141. Please see the full text HTML document for further details.Introduction :- L'un des facteurs de risque de la postmaturit\ue9 de la grossesse est la macrosomie foetale. Un enfant qui est excessivement grand provoque un probl\ue8me obst\ue9trique qui est r\ue9current et potentiellement grave. M\ue9thodes : Il s'agit d'une \ue9tude r\ue9trospective de toutes des naissances cons\ue9cutives dans le service d'obst\ue9trique, centre hospitalier universitaire de Jos, Jos, Nig\ue9ria, entre janvier 1998 et d\ue9cembre 2001. Les dossiers m\ue9dicaux de toutes les m\ue8res des enfants n\ue9s avec 4000g poids et de plus ont \ue9t\ue9 tir\ue9s et les donn\ue9es rassembl\ue9es et analys\ue9es pour accouchement total, des caract\ue9ristiques materneles et foetales, complications et le r\ue9sultat de la grossesse. R\ue9sultats : Enfants macrosomiques (4000g et lus) \ue9taient 286 soit 2,9% de tous accouchements. Dix soit 3,5% des enfants avec macrosomie \ue9taient pr\ue9terme, 90,9% \ue9taient terme. Et 5,6% \ue9taient post terme. L'\ue2ge moyen et la parit\ue9 des m\ue8res avec des grossesses \ue0 terme \ue9taient 29,2 ans, et 3,2 respectivement. Des m\ue8res post termes avaient un \ue2ge moyen et une parit\ue9 de 32,7 ans et 3,8 respectivement. Morbidit\ue9 maternelle comprend augmentation d'accouchement c\ue9sarien, et traumatisme vaginal. (\uc9pisiotomies, d\ue9chirures et des blessures l\ue9g\ue8res) dans les deux groupes. La c\ue9sarienne \ue9tait la m\ue9thode d'accouchement en 31.3% des post termes et 27,6% des enfants \ue0 terme, tandis que l'indication pour la c\ue9sarienne \ue9tait c\ue9phatopelvien dispropotionel en 80% et 87,3% pour des enfants post termes et \ue0 terme respectivement. Complications foetales \ue9taient la naissance asphyxie et mort \ue0 la naissance. Il n'y avait aucune abnormalit\ue9 foetale grave not\ue9e dans la s\ue9rie. Taux de mort \ue0 terme et enfants n\ue9s \ue0 post terme respectivement. Conclusion : Grossesses post termes constituent des b\ue9b\ue9es macrosomique dans notre centre. Ceci provoque une augmentation de risque pour des m\ue8res et foetus. Un diagnostique pr\ue9coce, surveillance d'intrapatum foetal et recours au accouchement \ue0 travers l'intervention chirurgicale pourrait am\ue9liorer le r\ue9sultat foetal chez ces enfants

Profile of Clients Requesting For Removal of Intrauterine Devices in Jos, Nigeria

Background: Intrauterine contraceptive devices are commonly used reversible methods of contraception in Jos, Nigeria. There is dearth of information on the effect of the IUD on client weight during the period of use. It is expected that the increased bleeding disorder associated with the intrauterine device may predispose to anaemia and some degree of weight loss. Method: A retrospective study of all patients having their previously inserted IUDs removed at the Jos University Teaching Hospital, Northern Nigeria, between January 1999 and December 2004. Results: The mean (\ub1 SD) age and parity of the clients was 32.9 \ub1 6.9 years and 4.0 \ub1 2.2 respectively. All the women were married and none of them was a nullipara. The TCu-380A IUD was used in 99.3% of the cases. The women were using the method for a mean of 51.5 \ub1 51.0 months or 4.3 years, and the commonest indication for removal was the desire for another pregnancy in 30.7% of the clients, followed by back pain in 12.6%. The mean weight (\ub1 SD) of the women at the insertion of the IUD was 66.67 \ub1 13.95 kg and the mean weight at the removal of the device was 69.3 \ub1 14.9 kg. The average weight gain with IUD use was therefore 2.6 kg. Conclusion: The observed weight increase in IUD users is probably occasioned by the annulment of the fear of pregnancy, and the tendency of women to gain weight with increasing age.Introduction : Ordinairement, on utilisait les st\ue9rilets contraceptifs comme des m\ue9thodes contraceptive \ue0 double face \ue0 Jos, Nig\ue9ria. Il y a la p\ue9nurie de l'information sur l'effet du st\ue9rilet (IUD) sur le poids du client au cours de la p\ue9riode de l'utilisation. Comme on doit s' y attendre l'augmentation dans des troubles saignants associ\ue9 au st\ue9rilet pourrait pr\ue9disposer \ue0 l'an\ue9mie et au quelques degr\ue9s de perte du poids. M\ue9thodes : Une \ue9tude \ue0 effet r\ue9troactif de tous les patients qui avaient auparavant subi l'enl\ue8vement de leur IUDs st\ue9rilets au centre h\uf4pitalier universitaire de Jos Nig\ue9ria du nord, entre janvier 1999 et d\ue9cembre 2004. R\ue9sultats : L'\ue2ge moyen (\ub1SD) et la parit\ue9 des clients \ue9tait 32, 9 \ub16,9 ans et 4,0\ub12,2 respectivement. Toutes les femmes sont mari\ue9es et aucune d'elles \ue9tait nulipara. Le TCu-380A IUD \ue9tait utilis\ue9 en 99,3% des cas. Les femmes utilisaient la m\ue9thode pour un moyen de 51,5\ub151,0 mois ou 4,3 ans, et l'indication la plus ordinaire pour l'enl\ue8vement \ue9tait le d\ue9sire pour une autre grossesse en 30,7% des clientes, suivi par mal de reins en 12,6%. Le poids moyen (\ub1SD) des femmes au cours d'insertion d'IUD \ue9tait 66,67\ub113,95Kg et le poids moyen pendant l'enl\ue8vement de la m\ue9thode \ue9tait 69,3\ub114,9Kg. En moyenne, le poids pris avec l'utilisation du IUD \ue9tait donc 2,6Kg. Conclusion : L'augmentation du poids not\ue9e chez les sujets qui utilisent IUD est peut-\ueatre attribuable \ue0 l'annulation de la peur d'un grossesse, et la possibilit\ue9 d'une augmentation du poids au fur et \ue0 mesure que les femmes deviennent de plus en plus \ue2g\ue9es

Elevated risk of stillbirth in males: systematic review and meta-analysis of more than 30 million births

Background Stillbirth rates have changed little over the last decade, and a high proportion of cases are unexplained. This meta-analysis examined whether there are inequalities in stillbirth risks according to sex. Methods A systematic review of the literature was conducted, and data were obtained on more than 30 million birth outcomes reported in observational studies. The pooled relative risk of stillbirth was estimated using random-effects models. Results The crude mean rate (stillbirths/1,000 total births) was 6.23 for males and 5.74 for females. The pooled relative risk was 1.10 (95% confidence interval (CI): 1.07-1.13). The attributable fraction in the whole population was 4.2% (95% CI: 3.70-4.63), and the attributable fraction among male fetuses was 7.8% (95% CI: 7.0-8.66). Study populations from countries with known sex-biased sex selection issues had anomalous stillbirth sex ratios and higher overall stillbirth risks than other countries, reflecting increased mortality among females. Conclusions Risk of stillbirth in males is elevated by about 10%. The population-attributable risk is comparable to smoking and equates to approximately 100,000 stillbirths per year globally. The pattern is consistent across countries of varying incomes. Given current difficulties in reducing stillbirth rates, work to understand the causes of excess male risk is warranted. We recommend that stillbirths are routinely recorded by sex. This will also assist in exposing prenatal sex selection as elevated or equal risks of stillbirth in females would be readily apparent and could therefore be used to trigger investigation

Fifteen Years Evaluation Of Haematocrit Values In Clients Accepting Minilaparotomy Sterilization In Jos, Nigeria

The study retrospectively evaluated the haematocrit values of clients accepting female sterilization over a 15year period in Jos University Teaching Hospital, Jos, Plateau State, Nigeria. Between January 1985 and December 1999, 2986 female sterilizations, through minilaparotomy, were performed. The mean (± SD) age and parity of the patients were 36.4 ± 4.2 years and 8 ± 2.0 respectively. 93.4% were between the ages 30-44years and 89.5% of them had delivered more than 5children. Interval sterilization was performed in 93.7% while 85% of the cases were done under local anesthesia. General anesthesia was used in 1.8% of the clients. The mean range of packed cell volume was 35.4%-39.6% with a mean (± SD) of 38.1 ± 2.9%. There was no anaemia related morbidity or mortality associated with the clients. The authors concluded that quality guidelines in voluntary surgical contraception ensured safety and continuity of services. Keywords: Haematocrit, Minilaparotomy, female sterilization.Journal of Mining and Geology Vol. 5 (1&2) 2006: pp. 5-1

Anthropometric and Other Assessment Indices of the Newborn in Jos, Nigeria

Background: Certain neonatal measurements are potential tools for evaluating the status of the newborn. The neonatal anthropometrics measurements and other assessment indices are therefore religiously performedby the attending midwife and entered into the labour room register. Method: This was a retrospective analysis of the infants delivered between January 2004 and December 2005 in the Jos University Teaching Hospital, Nigeria. Results: There were 4,266 deliveries during the study period. The mean age and parity of the mothers were 28.7 ± 5.8 and 3.0 ± 1.9 respectively. The mean gestational age of the infants at birth was 38.3 ± 2.8 weeks and the mean Apgar scores for the first and fifth minutes were 7.4 ± 1.7 and 8.5 ± 1.5 respectively. The mean birth weight of the babies was 3.1 ± 0.8 kg. The mean birth length and head circumference of the newborns were 47.2 ± 5.0 cm and 33.8 ± 2.9 cm respectively. The mean umbilical cord length was 52.9 ± 7.3 cm and the mean placental weight was 560 ± 118 grams. There were more male infants (53.1%) compared with female infants (46.9%) during the period of study. Twin infants contributed 3.8% of the deliveries in the study. Conclusion: Anthropometric and other assessments indices of the newborn infants at birth in Jos, Nigeria are similar to those in other parts of the country and the world.Fond: Les certaines mesures néo-natales sont des outils potentielles pour évaluer le statut du nouveau-né. Les mesures néo-natales de anthropometrics et les autres index d'évaluation religieusement sont donc exécutés par la sage-femme qui assiste et entré dans le registre de pièce travailliste. Méthode: Ceci était une analyse rétrospective des bébés livrés entre le 2004 janvier et le 2004 décembre dans l'Hôpital d'Enseignement d'Université de Jos, Nigéria. Résultats: Il y avait 4.266 livraisons pendant la période d'étude. L'âge et la parité moyen des mères étaient 28,7 ± 5,8 et 3,0 ± 1,9 respectivement. L'âge moyen de gestational des bébés à la naissance était 38,3 ± 2,8 semaines et les scores de Apgar moyens pour les premières et cinquièmes minutes étaient 7,4 ± 1,7 et 8,5 ± 1,5 respectivement. Le poids moyen de naissance des bébés était 3,1 ± 0,8 kg. La longueur moyens de naissance et la circonférence de tête du nouveau-né étaient 47,2 ± 5,0 cm et 33,8 ± 2,9 cm respectivement. La longueur moyenne de cordon ombilical était 52,9 ± 7,3 cm et le poids de placental moyen étaient 560 ± 118 grammes. Il y avait bébés plus des mâles (53.1 %) comparé aux bébés femelle (46.9 %) pendant la période d'étude. Les bébés jumeaux ont contribué 3,8% des livraisons dans l'étude. Conclusion: Anthropometric et les autres index d'évaluations des bébés nouveau-nés à la naissance dans Jos, Nigéria est similaire à ceux-là dans les autres parties du pays et le monde

POSTMATURITY AND FETAL MACROSOMIA IN JOS, NIGERIA

Background: One of the risk factors of post term pregnancy is fetal macrosomia. The excessively large infant presents a recurring and potentially serious obstetric problem. Methods:This was a retrospective study of all consecutive births in the maternity unit, Jos University Teaching Hospital, Jos, Nigeria, between January 1998 and December 2001. The case records of all mothers of babies born with weight of 4000g and above were retrieved and data collated and analyzed for total deliveries, maternal and fetal characteristics, complications and outcome of pregnancy. Results:Macrosomic infants (4000g and above) were 286 cases representing 2.9% of all deliveries. Ten (3.5%) of the infants with macrosomia were preterm, 90.9% were term, and 5.6% were post-term. The mean age and parity of the mothers with pregnancies at term was 29.2 years, and 3.2 respectively. The post term mothers had a mean age and parity of 32.7 years and 3.8 respectively. Maternal morbidity included increased caesarean delivery, and vaginal trauma (episiotomies, tears and bruises) in both groups. Caesarean section was the mode of delivery in 31.3% of post term and 27.6% term infants, while the indication for caesarean section was cephalopelvic disproportion in 80% and 87.3% for post term and term infants respectively. Fetal complications were birth asphyxia and stillbirth. There were no gross fetal abnormalities recorded in the series. Still birth rate was 8.1% and 12.5% in term and post term infants respectively. Conclusion: Post term pregnancies account for macrosomic babies in our facility, posing an increased risk to the mother and fetus. Early diagnosis, intrapartum fetal monitoring and recourse to operative delivery may improve the fetal outcome of these infants. A correction to this article has been issued in Annals of African Medicine, Vol. 4, No. 3, 2005, pp. 141. Please see the full text HTML document for further details

Norplant\uae Acceptors in Jos, Nigeria

Background :The Norplant contraceptive implant has since been an accepted long-term steroidal method of contraception in Jos. It is now competing favorably with the older methods in our center. Method: A retrospective study was carried out to review the trend and characteristics of the acceptors of this relatively new contraceptive method in Jos. Results: During the 26 months period of study, May 2002 to July 2004, a total of 3,793 women accepted modern contraceptive methods within the period of study. Two hundred and sixty (260) had Norplant insertion after due counseling, constituting 6.8% of all contraceptive methods in the center. All clients were married. Their age ranged from 18-48 years with a mean of 33.05 \ub1 5.33 years. The women were of parity 0-8 and a mean of 3.57 \ub1 1.58. They were also of weight ranging from 32-95 kg with a mean of 65.78 \ub1 11.74. Two hundred and forty eight 95.4% of them were literate. Eighty five percent (222) of the clients had used other methods of contraception before switching over to the Norplant implants. Ten percent of the women were continuing with the Norplant after previous usage, and continuation rate was 99.2%. The commonest source of information about the method was from health workers at family planning clinics in Jos. Conclusion: Norplant contraceptive method was used by about 7% of all clients accepting modern contraceptive methods. The women accepting the method were of lower age and parity compared with that of other methods. Majority of the clients switched from other methods to Norplant.Fond: L'implant contraceptif de Norplant a \ue9t\ue9 depuis longtemps accept\ue9 comme une m\ue9thode st\ue9ro\uefdale de contraception \ue0 long \ue0 Jos. Il concurrence maintenant favorablement avec les m\ue9thodes plus anciennes \ue0 notre centre. M\ue9thod: Une \ue9tude r\ue9trospective a \ue9t\ue9 effectu\ue9e pour passer en revue la tendance et les caract\ue9ristiques des accepteurs de cette m\ue9thode contraceptive relativement nouvelle \ue0 Jos. R\ue9sultats : Pendant une p\ue9riode d'\ue9tude de 26 mois, mai 2002 \ue0 juillet 2004, un total de 3,793 femmes ont accept\ue9 des m\ue9thodes contraceptives modernes au cours de la p\ue9riode de l'\ue9tude. Deux cents et soixante (260) ont eu l'insertion de Norplant apr\ue8s la consultation n\ue9cessaire, constituant 6,8% de toutes les m\ue9thodes contraceptives au centre. Tous les clients \ue9taient mari\ue9s. Leur \ue2ge s'est \ue9tendu de 18-48 ans avec un moyen du 33,05 \ub1 5,33 ans. Les femmes \ue9taient de la parit\ue9 0-8 et d'un moyen 3,57 \ub1 1,58. Elles \ue9taient \ue9galement du poids s'\ue9tendant de 32-95 kilogrammes avec un moyen 65,78 \ub1 11,74. Deux cents et quarante huit 95,4% d'entre elles \ue9taient instruits. Quatre-vingts cinq pour cent (222) des clients avaient utilis\ue9 d'autres m\ue9thodes de contraception avant qu'ils ne se soient orient\ue9s vers les implants de Norplant. Dix pour cent des femmes continuaient le Norplant apr\ue8s utilisation pr\ue9c\ue9dente, et le taux de continuation \ue9tait 99,2%. La source d'information la plus commune sur la m\ue9thode \ue9tait de personnel sanitaire aux cliniques de planification familiale \ue0 Jos. Conclusion: La m\ue9thode contraceptive de Norplant a \ue9t\ue9 employ\ue9e par environ de 7% de tous les clients qui ont accept\ue9 des m\ue9thodes contraceptives modernes. Les femmes qui ont accept\ue9 la m\ue9thode \ue9taient d'\ue2ge et de parit\ue9 inf\ue9rieurs compar\ue9s \ue0 celui d'autres m\ue9thodes. La majorit\ue9 des clients ont chang\ue9 d'autres m\ue9thodes \ue0 Norplant