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Background: The birthweight of a newborn is critical to their health, development, and well‐being. Previous studies that used maternal characteristics to predict birthweight did not employ a harmonised scale to assess the risk of low birthweight (LBW). Objective: The goal of this study was to develop a new instrument that uses items on a uniform scale to assess the risk of an LBW in a pregnant woman. Methods: Item response theory was employed to evaluate a similar existing scale, and some weaknesses were identified. Results: Based on the observed weaknesses of the existing scale, a new uniform scale was developed, which is a 3‐point Likert scale consisting of seven items. Conclusion: The scale, termed birthweight questionnaire, is a valuable tool for collecting data that could assist in assessing the risk of an LBW at every stage of pregnancy. [ABSTRACT FROM AUTHOR]

Background Nigeria has the largest global burden of HIV new infections in children despite global and national concerted efforts at the reduction of mother-to-child transmission of HIV. The goal of this study was to determine the associations between maternal characteristics, practices and mother-to-child transmission of HIV infection among mothers living with HIV. Methods This is a hospital-based descriptive cross-sectional study. Information was obtained using interviewer-administered questionnaire from the 240 participants. Data were analyzed with SPSS version 26, and P  < 0.05 was considered statistically significant. Results Out of the 240 mothers recruited, 129 (53.8%) were within 25–35 years of age, with a mean age of 31.08 ± 5.65. A total of 35 (14.6%) of the participants had at least a child with HIV infection. Maternal ART status before childbirth (AOR = 0.02, 95%CI = 0.01–0.05, P  = < 0.001) was the singular determinant of having a child with HIV infection. Mothers who delivered outside the health facility were about four-fold at risk of having an infected child (AOR = 3.89, 95%CI = 1.82–8.50, P  = 0.070). Conclusion The prevalence rate of mother-to-child transmission of HIV is high. Routine HIV testing services and the provision of accessible and affordable reproductive health services are recommended for all women of childbearing age. [ABSTRACT FROM AUTHOR]

Background: Oral health care behaviors during pregnancy affects maternal and child health outcomes. This scoping review sought to map the existing literature on the oral healthcare behaviors of pregnant women in Nigeria. Methods: PubMed, Science Direct, Web of Science, EBSCOHOST, Sabinet, African Index Medicus, and Scopus data based were searched in August 2023. Articles with reports on the oral health behavior of pregnant women in Nigeria, published in English in peer review were included in the review. Articles whose full lengths could not be accessed, and commentaries on studies, and letters to the editor were also excluded. Data on authors and year of publication of the study, study location, study objective, study design, methodological approach for data collection, and study outcomes were extracted and descriptively synthesized. Results: The search yielded a total of 595 articles of which 573 were unique. Only 21 articles were left after titles and abstracts screening and only 18 articles met the eligibility criteria. The proportion of pregnant women had utilized dental services ranged from 4 to 62.9%, the use of toothbrush and toothpaste ranged from 59.6 to 99.3%, twice daily tooth brushing ranged from 5.2 to 66.9%, and the use of toothbrush among pregnant women in the studies varies from 70.9 to 100%. Chewing stick was used by 0.1–27.7% of study participants. Dental problems such as caries, pain, swollen gums, and excessive salivation were reasons for seeking dental care. We identified individual, structural, and behavioral factors, including myths as barriers for dental service utilization. Conclusion: This scoping review shows that dental service utilization by pregnant women in Nigeria is poor and mainly due to curative than preventive needs. Oral health behaviours also need to be improved through tailored oral health education accessible to pregnant women in Nigeria. [ABSTRACT FROM AUTHOR]

Aim: This study was undertaken to determine the prevalence of Bacterial Vaginosis (BV), Trichomonas Vaginalis (TV) co-infection, and the antibacterial sensitivity profile of bacterial isolates. Methods: The study was a cross-sectional study of 232 pregnant women on a routine antenatal visit between April 2019 and Sept. 2020, at Amukoko clinic in Lagos, Nigeria. The gynaecologist conducted the clinical examination on each patient looking for vaginal discharge and its consistency/homogeneity, colour and odour. Two High Vaginal Swab (HVS) samples were taken from every patient and a semi-structured questionnaire was used to gather the socio-demographic, practices/attitudes, and clinical information of each participant. One sample was employed for wet preparation to identify the TV and BV diagnosis using Amsel's criteria and Whiff's test. The second sample was used for bacterial culture and antibiogram was conducted using the disc diffusion technique. The Clinical Laboratory Standard Institutes' (CLSI) interpretative criteria were used to categorise the results. Results: The mean age of the clients was 28.11 ± 7.08 years of age. The majority (88%) were aged 15–35 years. Only 81 (34.9%) had microbial organisms isolated or seen from their specimens and 19 (8.2%) of such were classified as having BV (Bacteriods or Gardnerella isolated). Of the 81 infected, 33 (40.8%) had only bacterial infection, 36 (44.4%) had TV alone and 12 (14.8%) had bacteria co-infected with TV. From the clinical records, the population that was classified as having UTI or vaginitis was only 46 (20.7%) The study observed age (15–35 years) related association between vaginosis/ TV co-infection (X2 = 7.9; P = 0.005). Participants with symptoms of vaginitis or UTI (mainly E. coli & pseudomonas spp. isolated), BV/co-infection with TV significantly associated with female traders (X2 = 8.5; P = 0.003) and were more associated with those from polygamous relationships (X2 = 18.79, P = 0.0001). Women in their 3rd and 2nd. trimester were more significantly associated with vaginal infection (X2 = 9.47, P = 0.002; X2 = 4.79, P = 0.029) respectively. The Pseudomonas showed susceptibility to ciprofloxacin (CIP) and cefuroxime (CXM). While, E. coli isolates were susceptible to cefepime, ciprofloxacin, and imipenem. Conclusion: There is a relatively low prevalence of BV and flagellate co-infection in the community studied. Recommendation: We recommend screening of antenatal women with underlying symptoms for BV and flagellates co-infection to avoid its progression to vaginitis. [ABSTRACT FROM AUTHOR]

Background: The decision-to-delivery interval (DDI) for a caesarean section is among the factors that reflect the quality of care a pregnant woman receives and the impact on maternal and foetal outcomes and should not exceed 30 min especially for Category 1 National Institute for Health and Care Excellence (NICE) guidelines. Herein, we evaluated the effect of decision-to-delivery interval on the maternal and perinatal outcomes among emergency caesarean deliveries at a secondary health facility in north-central Nigeria. Methods: We conducted a four-year retrospective descriptive analysis of all emergency caesarean sections at a secondary health facility in north-central Nigeria. We included pregnant mothers who had emergency caesarean delivery at the study site from February 10, 2017, to February 9, 2021. Results: Out of 582 who underwent an emergency caesarean section, 550 (94.5%) had a delayed decision-to-delivery interval. The factors associated with delayed decision-to-delivery interval included educational levels (both parents), maternal occupation, and booking status. The delayed decision-to-delivery interval was associated with an increase in perinatal deaths with an odds ratio (OR) of 6.9 (95% CI, 3.166 to 15.040), and increased odds of Special Care Baby Unit (SCBU) admissions (OR 9.8, 95% CI 2.417 to 39.333). Among the maternal outcomes, delayed decision-to-delivery interval was associated with increased odds of sepsis (OR 4.2, 95% CI 1.960 to 8.933), hypotension (OR 3.8, 95% 1.626 TO 9.035), and cardiac arrest (OR 19.5, 95% CI 4.634 to 82.059). Conclusion: This study shows a very low optimum DDI, which was associated with educational levels, maternal occupation, and booking status. The delayed DDI increased the odds of perinatal deaths, SCBU admission, and maternal-related complications. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is a serious threat to first-time pregnancy. Objective: To determine the knowledge, attitude, and practice (KAP) regarding gestational diabetes mellitus (GDM) among pregnant women on antenatal appointment in government approved healthcare facilities in Nigeria and also to establish the significant correlation and association within sociodemographic variables. Methods: It was a facility-based cross-sectional study, conducted in government-approved healthcare facilities in Nigeria, from January to March, 2023. A total of 1750 pregnant women were sampled and surveyed using convenient sampling technique. Data were collected using an adapted questionnaire "Gestational Diabetes Mellitus Knowledge, Attitude and Practice Questionnaire" with 0.87 reliability index. Statistical analysis was completed using IBM SPSS version 22. Frequency, percentage, odds ratio statistics, and chi-square test were applied for data analysis. All computations were deemed statistically significant at p value ≤ 0.05. Results: Out of 1750 eligible participants, 1488 (88.4%) valid responses were analyzed. The study showed that 69% knew about GDM, 65% had positive attitude, and 79% had desirable GDM practice. Statistically, there were strong correlation between KAP regarding GDM and age, marital status, education level, and parity status (odds ratio ≥ 1). Furthermore, the KAP regarding GDM was significantly associated with alcohol consumption, education, parity status, and resident (p value < 0.05), respectively. Conclusion: Approximately three-quarter of the pregnant women knew about GDM, had positive attitude, and had desirable GDM practice. The KAP regarding GDM was strongly correlated and significantly associated with sociodemographic variables. Facility-based interventions on KAP regarding GDM are paramount to be incorporated in the national health programs to improve knowledge and enhance attitude and GDM practices. [ABSTRACT FROM AUTHOR]

Background: Unskilled delivery, particularly the use of traditional birth attendants, is a major threat to reducing maternal mortality in Africa. Despite the associated risks, there is insufficient evidence on the major reasons why pregnant women in Nigeria continue to use traditional birth attendant (TBA) services, especially in rural areas. This study, therefore, assessed the perception, reasons for use, and utilization of only TBA services in current pregnancy among rural-dwelling pregnant women in Lagos, Nigeria. Methods: A descriptive cross-sectional study was conducted among 347 pregnant women recruited from traditional birth attendant facilities at Ikorodu Local Government Area, Lagos. Data were collected with an interviewer-administered questionnaire and analyzed using SPSS version 25. Bivariate and multivariate analyses were conducted with a significance level set at p<0.05. The outcome measures included perception, utilization of only TBA services in current pregnancy, and reasons for use. Positive perception refers to positive thought, belief, or opinionheld by the participants towards the TBA. Results: All the respondents had a positive perception of TBAs, majority (70.3%) utilized TBA only while 29.7% combined TBA and healthcare facilities services in the current pregnancy. Recommendations from previous users (81.6%), welcoming and hospitable staff (77.2%), perceived spiritual protection (75.2%), and past use (68.6%), were some of the reasons cited by the respondents for utilizing only TBA services. Predictors of utilizing only TBA services were respondents' level of education, those with secondary (aOR = 0.261; 95% CI; 0.108–0.629) and tertiary (aOR = 0.352; 95% CI; 0.162–0.769) had lower utilization while the lack of health insurance coverage (aOR = 3.017; 95% CI; 1.476–6.166) were associated with higher utilization of TBAs. Conclusion: Respondents in this study had a positive perception of TBA services. Continuous training and an effective monitoring system of TBAs by the government and other healthcare stakeholders to improve women's birthing experiences is recommended. [ABSTRACT FROM AUTHOR]

Background: The practice of intrapartum use of oxytocin for induction and augmentation of labour is increasing worldwide with documented wide variations in clinical use, especially dose administrations. There is also evidence of intrapartum use by unauthorized cadre of staff. Aim: This study assessed the patterns – frequency of intrapartum use of oxytocin, the doses and routes of administration for induction and augmentation of labour, and identified the predictors of oxytocin use for induction and augmentation of labour by healthcare providers in Nigeria. Methods: This was a cross-sectional study conducted among healthcare providers – doctors, nurses/midwives and community health workers (CHWs) in public and private healthcare facilities across the country's six geopolitical zones. A multistage sampling technique was used to select 6,299 eligible healthcare providers who use oxytocin for pregnant women during labour and delivery. A self-administered questionnaire was used to collect relevant data and analysed using STATA 17 statistical software. Summary and inferential statistics were done and further analyses using multivariable regression models were performed to ascertain independent predictor variables of correct patterns of intrapartum oxytocin usage. The p-value was set at < 0.05. Results: Of the 6299 respondents who participated in the study, 1179 (18.7%), 3362 (53.4%), and 1758 (27.9%) were doctors, nurses/midwives and CHWs, respectively. Among the respondents, 4200 (66.7%) use oxytocin for augmentation of labour while 3314 (52.6%) use it for induction of labour. Of the 1758 CHWs, 37.8% and 49% use oxytocin for induction and augmentation of labour, respectively. About 10% of the respondents who use oxytocin for the induction or augmentation of labour incorrectly use the intramuscular route of administration and about 8% incorrectly use intravenous push. Being a doctor, and a healthcare provider from government health facilities were independent positive predictors of the administration of correct dose oxytocin for induction and augmentation of labour. The CHWs were most likely to use the wrong route and dose administration of oxytocin for the induction and augmentation of labour. Conclusion: Our study unveiled a concerning clinical practice of intrapartum oxytocin use by healthcare providers in Nigeria – prevalence of intrapartum use of oxytocin, inappropriate routes of administration for induction and augmentation of labour, varied and inappropriately high start dose of administration including unauthorized and high intrapartum use of oxytocin among CHWs. [ABSTRACT FROM AUTHOR]

Objectives: The study evaluated sub-microscopic malaria infections in pregnancy using two malaria Rapid Diagnostic Tests (mRDTs), microscopy and RT-PCR and characterized Plasmodium falciparum dihydrofolate reductase (Pfdhfr) and Plasmodium falciparum dihydropteroate synthase (Pfdhps) drug resistant markers in positive samples. Methods: This was a cross sectional survey of 121 pregnant women. Participants were finger pricked, blood drops were collected for rapid diagnosis with P. falciparum histidine-rich protein 11 rapid diagnostic test kit and the ultra-sensitive Alere Pf malaria RDT, Blood smears for microscopy and dried blood spots on Whatman filter paper for molecular analysis were made. Real time PCR targeting the var acidic terminal sequence (varATS) gene of P. falciparum was carried out on a CFX 96 real time system thermocycler (BioRad) in discriminating malaria infections. For each run, laboratory strain of P. falciparum 3D7 and nuclease free water were used as positive and negative controls respectively. Additionally, High resolution melt analyses was employed for genotyping of the different drug resistance markers. Results: Out of one hundred and twenty-one pregnant women sampled, the SD Bioline™ Malaria Ag P.f HRP2-based malaria rapid diagnostic test (mRDT) detected eight (0.06%) cases, the ultra-sensitive Alere™ malaria Ag P.f rapid diagnostic test mRDT had similar outcome in the same samples as detected by the HRP2-based mRDT. Microscopy and RT-PCR confirmed four out of the eight infections detected by both rapid diagnostic tests as true positive and RT-PCR further detected three false negative samples by the two mRDTs providing a sub-microscopic malaria prevalence of 3.3%. Single nucleotide polymorphism in Pfdhps gene associated with sulphadoxine resistance revealed the presence of S613 mutant genotypes in three of the seven positive isolates and isolates with mixed wild/mutant genotype at codon A613S. Furthermore, four mixed genotypes at the A581G codon were also recorded while the other Pfdhps codons (A436G, A437G and K540E) showed the presence of wild type alleles. In the Pfdhfr gene, there were mutations in 28.6%, 28.6%, and 85.7% at the I51, R59 and N108 codons respectively. Mixed wild and mutant type genotypes were also observed in 28.6% each of the N51I, and C59R codons. For the Pfcrt, two haplotypes CVMNK and CVIET were observed. The SVMNT was altogether absent. Triple mutant CVIET 1(14.3%) and triple mutant + wild genotype CVIET + CVMNK 1(14.3%) were observed. The Pfmdr1 haplotypes were single mutants YYND 1(14.3%); NFND 1(14.3%) and double mutants YFND 4(57.1%); YYDD 1(14.3%). [ABSTRACT FROM AUTHOR]

Although a sizable number of pregnant women patronize Traditional Birth Attendants (TBAs) for deliveries in Nigeria, efforts to prevent or reduce the risk of HBV transmission are not targeted at the TBAs and the pregnant women patronizing them. This may be linked to the dearth of information on the serological profiles of HBV among this cohort. We, therefore, show the serological profiles of HBV among the cohort. One hundred and seventy pregnant women and 91 TBAs participated in this study between May and July 2019. Serological markers of HBV infection were assayed using ELISA. A prevalence of, 8.0% (95% CI: 5.0% − 11.5%) for HBsAg, 0.8% (95% CI: 0.0% − 1.9%) for HBeAg, 2.7% (95% CI: 0.8% − 5.0%) for HBcIgM, 26.1% (95% CI: 20.7% − 31.4%) for anti-HBs, 21.5% (95% CI: 16.5% − 25.4%) for anti-HBe and 67.0% (95% CI: 60.9% – 72.8%) for anti-HBc was found indicating a high percentage of carriers. Although 32 (12.3%) of the entire participants claimed to be fully vaccinated, serological evidence was only detected in 4 (12.5%). The high percentage of carriers and low evidence of vaccination necessitate intensified efforts to ensure that adequate interventions are made available and accessible to the TBAs and the pregnant women patronizing them (including newborn babies). [ABSTRACT FROM AUTHOR]

BACKGROUND: Effective family support is essential for promoting the well-being of pregnant women and reducing the risk of adverse pregnancy outcomes. This study examined family support patterns and influencing factors among pregnant women attending antenatal clinics in Ile-Ife, Nigeria. METHODS: This descriptive cross-sectional study involved 384 pregnant women in a Local Government Area in southwestern Nigeria. Three healthcare facilities with the highest antenatal attendance were selected through purposive sampling. Data were collected using a tested and structured questionnaire, which was developed following a review of similar studies. The results were analyzed using SPSS version 20.0, employing Pearson Chi-square tests with a significance level set at p < 0.05. RESULTS: More than half of the respondents reported inadequate family support in various aspects including tangible/instrumental support (52.9%), emotional support (51.4%), and financial support (54.4%). However, the majority reported significant financial supports from their spouses (60.7%). Religion, educational qualification, and partner's occupation were found to significantly influence the likelihood of women receiving higher levels of social support. CONCLUSION: Many respondents lacked adequate support from spouses and families. Encouraging family involvement in antenatal care can improve understanding and support, benefiting maternal and child health. Hence, healthcare professionals and policymakers should consider the factors influencing family support options when designing focused interventions to strengthen maternal support systems and address the varied needs of pregnant women. [ABSTRACT FROM AUTHOR]

Background Eclampsia causes maternal mortality in Nigeria. This study presents the effectiveness of multifaceted interventions that addressed institutional barriers in reducing the incidence and case fatality rates associated with eclampsia. Methods The design was quasi-experimental and the activities implemented at intervention hospitals included a new strategic plan, retraining health providers on eclampsia management protocols, clinical reviews of delivery care and educating pregnant women and their partners. Prospective data were collected monthly on eclampsia and related indicators from study sites over 2 y. The results were analysed by univariate, bivariate and multivariable logistic regression. Results The results show a higher eclampsia rate (5.88% vs 2.45%) and a lower use of partograph and antenatal care (ANC; 17.99% vs 23.42%) in control compared with intervention hospitals, but similar case fatality rates of <1%. Overall, adjusted analysis shows a 63% decrease in the odds of eclampsia at intervention compared with control hospitals. Factors associated with eclampsia were ANC, referral for care from other facilities and older maternal age. Conclusion We conclude that multifaceted interventions that address challenges associated with managing pre-eclampsia and eclampsia in health facilities can reduce eclampsia occurrence in referral facilities in Nigeria and potential eclampsia death in resource-poor African countries. [ABSTRACT FROM AUTHOR]

Background: Nigeria remains a major contributor to neonatal deaths worldwide, yet little consideration has been given to intra/inter health facility transfer of sick neonates. The dearth of Neonatal Transport Network Services (NNTS) is probably an underappreciated driver of the abysmally high national neonatal mortality indices. This study aimed to evaluate neonatal transport services and the healthcare workers' preparedness among health facilities in Port Harcourt Metropolis, Rivers State, Nigeria. Methods: Twenty-eight selected health facilities (tertiary, private hospitals Primary Health Centers] were assessed on the availability, modality and practice of NNTS. Data was analyzed using SPSS Version 23. Results: Routine transfer of high-risk pregnant mothers to higher levels of care occurred always in 14 (50%) and sometimes in 6 (21.4%) facilities; Private cars and taxis were the most common mode of transport in 24 (85.7%) facilities. Two facilities (7.2%) had ambulances equipped with transport incubators. Nurses and nurse attendants with no formal training in NNTS accompanied referred neonates in 2 (7.2%) facilities. Most referring facilities (78.6%) neither rarely or never contacted receiving centres before the arrival of neonates and most nor gave back referrals after offering neonatal care. None (100%) of the facilities had a trained emergency transport team. Conclusion: Health facilities in Southern Nigeria lack a standardized Neonatal Transport Network and are characterized by poor communication between health facilities and inadequately trained personnel for inter-facility transfer of sick neonates. Urgent action is required to address these gaps, including training of healthcare workers on neonatal transport and sharing findings with relevant stakeholders/policymakers to establish a functional neonatal transport network among health facilities. [ABSTRACT FROM AUTHOR]

Background: The fear of positive HIV results has been reported as a determinant of HIV testing among pregnant women and women of reproductive age. When pregnant women know about discriminatory practices toward other people based on their HIV-positive status, it may impact their testing for HIV. Therefore, the purpose of this study was to examine the association between Nigerian pregnant women's knowledge of discriminatory practices against persons living with HIV and their self-reported HIV testing during antenatal visits or childbirth. Methodology: A secondary analysis of data from 659 t women who had experienced pregnancy aged 15-49 years from the 2013 Nigeria Demographic Health Survey (NDHS) was done. Multivariable logistic regression analysis was done to determine the association between knowledge about discriminatory practices towards HIV-positive individuals (independent variable) and HIV testing during pregnancy (dependent variable) after controlling for covariates (demographic characteristics). A P-value of = 0.05 was taken as statistically significant. Results: Bivariate logistic regression analysis findings showed that educational level, place of residence, and religion statistically significantly predicted HIV testing of pregnant women, while age categories and marital status did not. The women's knowledge of discriminatory practices towards persons living with HIV/AIDS was not statistically significant at Alpha = 0.05 (AOR, 1.51; 95% CI: .46, 4.95) Higher levels of education (Primary Education, AOR = 1.81; 95% CI: 1.03, 3.18; Secondary Education, AOR = 3.73; 95% CI: 1.92, 7.25; Higher Education, AOR = 10.92; 95% CI: 4.25, 28.05) and those living in urban areas (AOR = 1.62; 95% CI: 1.04, 2.51) were significantly associated with testing for HIV in the stepwise multivariable regression model of pregnant women's knowledge of discriminatory practices towards persons living with HIV/AIDS. Conclusion: Although knowledge of discriminatory practices did not predict pregnant women's HIV testing in this study, interventions by stakeholders to eliminate or reduce these practices should be stepped up towards facilitating positive social change. [ABSTRACT FROM AUTHOR]

Background: Pregnancy serves as a physiological stress test for the thyroid which often leads to dysfunction in women with limited thyroid reserves. The occurrence of gestational thyroid dysfunction is linked to unfavourable obstetric and foetal outcomes. Globally, iodine deficiency is a prominent causative factor for thyroid dysfunction. The study aimed to determine the prevalence and pattern of thyroid dysfunction among pregnant women in Enugu, South-east Nigeria. Methodology: This hospital-based descriptive cross-sectional and observational study was conducted over six months on selected participants from pregnant women attending antenatal clinics at the study sites. Maternal clinical and demographic risk factors for thyroid dysfunction were evaluated in a cohort of 318 pregnant women. An analysis of variance (ANOVA) was performed to compare participants' thyroid status across different trimesters of pregnancy, and different thyroid and nutritional iodine states. Result: The prevalence of thyroid dysfunction in the study population is 6.6%. Hypothyroidism was detected in 5.3% of the participants, consisting of 3.8% sub-clinical hypothyroidism and 1.6% overt hypothyroidism. Subclinical hyperthyroidism accounted for 1.3% of all participants; no overt hyperthyroidism was detected in this study. Conclusion: There is a relatively high prevalence of gestational thyroid dysfunction in the study population with hypothyroidism being the predominant disorder. This highlights the need for region-specific considerations in antenatal care to facilitate early detection and effective management of gestational thyroid dysfunction, thereby mitigating potential adverse maternal and foetal outcomes. [ABSTRACT FROM AUTHOR]

Background: Cytomegalovirus (CMV) infection especially in pregnancy may cause complications such as congenital infections leading to neurological disabilities in children that result in blindness, neuro-developmental delay, and sensory neural hearing loss. This study was carried out to determine the seroprevalence of cytomegalovirus infection among pregnant women attending antenatal clinics in Yusuf Dan Tsoho and 44 Nigerian Army Reference Hospitals in Kaduna metropolis. Materials and Methods: Blood samples were collected from ninety-two pregnant women and screened for CMV IgM antibodies using ELISA. Structured questionnaire was used to obtain data on socio-demographic and risk factors associated with the CMV infection. Results: Out of the 92 pregnant women examined, 30 (32.6%) tested positive to CMV IgM antibodies. There was statistically significant association between CMV infection and occupation, previous pregnancy and sharing of cups or utensils. There was no significant association between CMV infection and marital status, gestation age, history of blood transfusion, age and educational level. Conclusion: The high prevalence of CMV infection observed in this study indicates that the virus is prevalent in the study area, and it is therefore advisable that routine screening of CMV infection be implemented for all pregnant women in the State. [ABSTRACT FROM AUTHOR]

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Objective: The primary purpose of this study was to examine whether pregnant women with a history of recurrent pregnancy loss (RPL) are more likely to experience moderate-to-severe depression, anxiety, or stress symptoms than pregnant women without a history of RPL. The secondary purpose was to determine whether women with prior RPL experienced more unfavorable pregnancy outcomes if they had depression, anxiety, or stress. Methods: A prospective case-control study was conducted that included 47 pregnant women with a history of RPL and 94 pregnant women without prior RPL. Participants 20 weeks of gestation or earlier were included. Both groups completed the Depression, Anxiety, and Stress Scale (DASS-21), and were followed up until delivery to determine the pregnancy outcomes. Multivariate logistic regression was used to compare adverse pregnancy outcomes. Result: Among the 47 women with prior RPL, 10 had primary RPL (two or more miscarriages without a successful pregnancy) and 37 secondary RPL (two or more miscarriages with a history of successful pregnancy). RPL was significantly associated with moderate-to-severe levels of depression (P < .001), anxiety (P < .001), and stress (P < .001). Among the RPL group, high stress level was significantly associated with repeat miscarriage (adjusted odds ratio (AOR) = 5.28, 95%CI = 1.25-100.0, P = .03) and preterm labor (AOR = 6.07, 95%CI = 1.61-100.0, P = .04). Depression and anxiety were not associated with adverse pregnancy outcomes. Conclusion: Pregnant women with a history of RPL had considerably higher rates of moderate-to-severe depression, anxiety, and stress. Repeat miscarriage and preterm labor were considerably higher among pregnant women with RPL who were experiencing high stress levels at baseline. [ABSTRACT FROM AUTHOR]

Background: Pregnancy presents a critical period for any maternal and child health intervention that may impact the health of the newborn. With low antenatal care attendance by pregnant women in health facilities in Nigeria, community-based programs could enable increased reach for health education about sickle cell disease (SCD) and newborn screening (NBS) among pregnant women. This pilot study aimed to assess the effect of education on the knowledge about SCD and NBS among pregnant women using the Healthy Beginning Initiative, a community-based framework. Methods: A pre-post study design was used to evaluate knowledge of SCD and NBS in a convenience sample of 89 consenting pregnant women from three communities. Participants were given surveys prior to and following completion of a health education session. McNemar's test was used to compare the proportion of participants with correct responses. The level of significance was taken as p < 0.05. Results: Compared to pre-test values, post-test values showed that participants understood that SCD is hereditary (93.3% vs. 69.7%), both parents must have at least one gene for someone to have SCD (98.9% vs. 77.5) and blood test is the right way to know if one has SCD (98.8% vs. 78.7%). Also, a large proportion of participants (post-test ~ 89.9%; compared to pre-test ~ 23.6%) understood that the chance of conceiving a child with SCD was 25% for a couple with the sickle cell trait (SCT). Knowledge of the possibility of diagnosing SCD shortly after birth was highly increased in the post test phase of the study when compared to the pre-test phase (93.3% vs. 43.9%, respectively). Concerning the overall knowledge scores, those with high level of knowledge significantly increase from 12.6% pretest to 87.4% posttest (p = 0.015). Conclusion: The health education intervention was associated with significant improvement on almost all measures of SCD knowledge. Focused health education for pregnant women using community structures can improve knowledge of SCD and NBS. [ABSTRACT FROM AUTHOR]

Background: Sleep is essential for pregnant women's and the offspring's health and wellbeing. Poor sleep and disorders have been linked with adverse fetal outcomes and delivery conditions. However, pregnant women often experience several forms of sleep disruption, which has been scarcely reported in low and middle-income countries (LMIC), including Nigeria where the influence of lifestyle factors has also been lacking. We investigated sleep patterns and disorders and the associated factors among pregnant women in Southwest, Nigeria. Method: A cross-sectional study was conducted among five hundred (500) pregnant women attending Adeoyo Maternity Teaching Hospital. A semi-structured questionnaire was used to examine different domains of sleep and associated disorders, namely sleep quality (Pittsburgh Sleep Quality Index (> 5 and ≤ 5)), insomnia (Insomnia Severity Index (> 8 and ≤ 8)), restless leg syndrome (Restless Leg Syndrome Rating Scale (> 10 and ≤ 10). Significant covariates such as physical activity, minimum dietary diversity, smoking and alcohol intake were also assessed. We conducted bivariate and multivariate analysis at p < 0.05 significance level. Results: The mean age of participants was 30.4 ± 4.8 years. The pattern of sleep disorder in pregnant were poor sleep quality (50%), restless leg syndrome (58.2%) and insomnia (33.4%). Being currently married (AOR = 6.13; 95% CI: (1.65–22.23)), increasing gestational age: second trimester (AOR = 8.25;95% CI: (1.78–38.17)) to third trimester (AOR = 10.98; 95% CI: (2.44–49.48)) increased the odds of poor sleep quality. Factors associated with restless leg syndrome were marital status [AOR = 3.60; 95% CI; (1.25–10.35)], religion, rigorous physical activities [AOR = 1.52; 95% CI: (1.05–2.21)] and alcohol consumption [AOR = 3.51; 95% CI: (1.00–12.27)]. Factors associated with insomnia were maternal age [AOR = 1.83; 95% CI: (1.11–3.01)], income [AOR = 2.99 (1.26–7.16)] and rigorous physical activity [AOR = 2.55 (1.61–4.02)]. Conclusion: Poor sleep quality, restless leg syndrome and insomnia were typical among pregnant women in Ibadan, Southwest Nigeria. Thus, awareness and education on the importance of sleep and its risk and protective factors, such as alcohol consumption, smoking, rigorous activity and spousal and family support, should be increased to reduce poor sleep quality and sleep disorders (restless leg syndrome and insomnia) during the pregnancy period. [ABSTRACT FROM AUTHOR]

Background: Body image perception and social support during pregnancy can impact the psychological distress levels experienced by pregnant women. As a result, the purpose of this study was to examine the relationship between various components of social support and body image perception on psychological distress levels among pregnant women in their third trimester in Nigeria. Method: A cross-sectional study was conducted among 246 pregnant women who were in the third trimester and attending selected health care facilities in Ogbomoso, a semiurban city in Oyo State, Nigeria. Body image perception, social support, and psychological distress scales were used to collect the data. Data were analyzed and summarized using descriptive and inferential statistics (ANOVA and multiple regression), with significance set at p < 0.05. Results: Regression analysis showed that 44% of the variation in psychological distress among pregnant women was explained by the background variables, marital status, body image perception, appraisal support, tangible support, belonging support, interaction between body image perception and appraisal support, belong support and tangible support. Conclusion: Intervention programs focusing on bolstering tangible support, belonging support and appraisal support are recommended at reducing the psychological distress due to body image perception among pregnant women at third trimester. [ABSTRACT FROM AUTHOR]

Malaria presents a huge threat to pregnant women, their foetus, and children below five years. This study is aimed at assessing malaria prevalence, associated clinical symptoms, and urine abnormalities among pregnant women in Aba metropolis, Abia State, Nigeria. A cross-sectional study involving 450 pregnant women purposively selected from nine health care centres was conducted. Data were analysed using SPSS version 26. The overall malaria prevalence rate was 68.4% (n = 308). Age group of 21-25 years had the highest prevalence rate of 20.4% (n = 92) while the least was recorded among the age group of 41-45 years (17 (3.8%)). Pregnant women in their first trimester had the greatest prevalence rate of 28.6% (n = 129), and the least prevalence was recorded among those in their third trimester (7 (15.6%)). The primigravidae were mostly infected at the rate of 27.7% (n = 125) whereas the multigravidae recorded the least prevalence of 85 (18.9%). Participants with secondary education were the most susceptible at the rate of 38.6% (n = 174). The infected participants exhibited significantly higher frequencies of reported fever (p > 0.001 , OR 12.881, 95% CI 3.977-41.725) and headaches (p < 0.001 , OR 4.688, 95% CI 1.819-12.083). However, cold, cough, body pains, poor appetite, and catarrh showed no significant association with malaria infection at p > 0.05. Participants using long-lasting insecticidal nets (LLINs) showed significantly lower prevalence rate of malaria infection (p < 0.001 , OR 2.485, 95% CI 1.619-3.814). Malaria-infected participants showed statistically significant frequencies of proteinuria (p < 0.001 , OR 274.14, 95% CI 16.91-4444.0), bilirubinuria (p < 0.001 , OR 49.29, 95% CI 11.01-186.34), and urobilinogenuria (p < 0.001 , OR 65.16, 95% CI 4.00-1062.40) than those not infected. Ascorbic acid, nitrate, and ketone showed no significant associations with malaria infection at p > 0.005. Infected participants had statistically significant amber and clear urine colour whereas there was no statistically significant difference between the pH levels of urine of the malaria-infected and malaria-noninfected pregnant women. [ABSTRACT FROM AUTHOR]

Background: Severe infections caused by carbapenem-resistant Enterobacteriaceae (CRE) have mortality rate exceeding 50%. On the strength of this, this study sought to determine the prevalence of urinary tract infection (UTI) in pregnancy caused by CRE and associated risk factors in University of Calabar Teaching Hospital (UCTH), Nigeria, with the aim of making recommendations that can stem the tide of UTI caused by this bacterial strain in the hospital. Methodology: This was a descriptive cross-sectional study of 349 consecutively selected pregnant women attending antenatal clinic of UCTH, Calabar, Nigeria, between September 2020 and August 2021. Demographic/clinical data and risk factors were collected with semi-structured interviewer-administered questionnaire. Voided mid-stream urine (MSU) sample was collected from each participant and transported to the medical microbiology laboratory of the hospital for microbiological analysis using conventional culture and biochemical identification methods. Antimicrobial susceptibility test (AST) on each isolate was performed by the disk diffusion technique against selected antibiotics. Phenotypic carbapenemase production from presumptive carbapenem resistant isolates following AST was confirmed by the modified Hodge test (MHT). Data analysis was done on SPSS version 19.0. Association of risk factors with prevalence of UTI caused by CRE was determined using Chi square or Fisher Exact test, with p<0.05 considered statistically significant. Results: The prevalence of UTI among the pregnant women was 10.0% (35/349), with prevalence of 6.6% for Escherichia coli (23/349) and 3.5% (12/349) for Klebsiella pneumoniae. Antibiotic susceptibility test result showed that piperacillin-tazobactam was the most active antibiotic in vitro, with 82.9% isolates sensitive to it while sensitivity to imipenem (60.0%) and meropenem (40.0%) was low. A total 17 (48.6%) of the 35 isolates were resistant to carbapenems in the AST and 12 (34.3%) were carbapenemase-producing strains on MHT while 5 (14.3%) were non-carbapenemase-mediated resistance (NCMR). None of the demographic characteristics or risk factors analysed was significantly associated with UTI caused by CRE in the pregnant women (p>0.05). Conclusion: To stem the rising trend of UTIs in pregnancy caused by carbapenem resistant uropathogens, pregnant women receiving antenatal care in UCTH, Calabar should be routinely screened for UTI and offered appropriate treatment if indicated based on microbiological test results [ABSTRACT FROM AUTHOR]

Despite the vast advantages of making antenatal care visits, the service utilization among pregnant women in Nigeria is suboptimal. A five-year monitoring estimate indicated that about 24% of the women who had live births made no visit. The non-utilization induced excessive zeroes in the outcome of interest. Thus, this study adopted a zero-inflated negative binomial model within a Bayesian framework to identify the spatial pattern and the key factors hindering antenatal care utilization in Nigeria. We overcome the intractability associated with posterior inference by adopting a Pólya-Gamma data-augmentation technique to facilitate inference. The Gibbs sampling algorithm was used to draw samples from the joint posterior distribution. Results revealed that type of place of residence, maternal level of education, access to mass media, household work index, and woman's working status have significant effects on the use of antenatal care services. Findings identified substantial state-level spatial disparity in antenatal care utilization across the country. Cost-effective techniques to achieve an acceptable frequency of utilization include the creation of a community-specific awareness to emphasize the importance and benefits of the appropriate utilization. Special consideration should be given to older pregnant women, women in poor antenatal utilization states, and women residing in poor road network regions. [ABSTRACT FROM AUTHOR]

Background: Admission cardiotocography (CTG), a noninvasive procedure, is used to indicate the state of oxygenation of the fetus on admission into the labor ward. Objective: This study assessed the association of admission CTG findings with neonatal outcome at a tertiary health facility. Materials and Methods: A prospective, observational study of 206 pregnant women who were admitted into the labor ward with singleton live pregnancies. Information on the demographic characteristics, obstetrics and medical history, admission CTG tracing, and neonatal outcome was obtained using a structured data collection form. Data were analyzed using the SPSS software version 20.0 with the level of significance set at P < 0.05. Results: The admission CTG findings were normal in 73.3%, suspicious in 13.6%, and pathological in 13.1% of the women. The occurrence of low birth weight, special care baby unit (SCBU) admission, asphyxiated neonates, neonatal death, and prolonged hospital admission was significantly more frequent among those with pathological admission CTG results compared with normal and suspicious results (P < 0.05). The incidence of vaginal delivery was more common when the CTG findings were normal, whereas all women with pathological CTG result had a cesarean delivery. Conclusion: Admission CTG was effective in identifying fetuses with a higher incidence of perinatal asphyxia. Neonatal outcome such as low birth weight, APGAR score, SCBU admission, and prolonged hospital admission was significantly associated with pathological CTG findings. In the absence of facilities for further investigations, prompt intervention for delivery should be ensured if admission CTG is pathological. [ABSTRACT FROM AUTHOR]

Acute hepatitis B virus (HBV) and malaria infections pose serious health risks to the general population and may worsen victims' physical and financial well-being. The objective of this study was to determine the frequency of HBV and malaria co-infections during LGA among expectant mothers. This study used a cross-sectional, prospective design. Blood samples were collected from both pregnant and non-pregnant women for parasitological and serological examinations in the study area. This was performed to compare the severity of infections between pregnant and non-pregnant women, as pregnant women are more susceptible to infections. The study included 50 women who attended antenatal care at the time of this project and 10 non-pregnant women who came to the hospitals for check-ups. Samples of people aged 18 to 52 years were collected. Age groups of 18-28 and 40-50 years had the greatest 30(50%) and lowest 8(13%) populations of women screened for malaria and hepatitis B co-infection, respectively. The 1st and 3rd trimesters were followed by the 2nd trimester, which had the highest prevalence. Only the second trimester had a 2% prevalence rate of hepatitis B. Farmers were the group most likely to contract malaria (92%). The percentage of government employees who had malaria and hepatitis B was the highest (20%), followed by traders (5%). Ogrute, the seat of the Local Government had a high rate of malaria infection despite having several medical facilities and less farming activities. Olido (25%), followed by Ogrute (14 point 3%), had the highest rate of co-infection with hepatitis B and malaria. The PCV ranges of 25-27(100%) and 28-30(100%) had the highest prevalence of malaria. This study shows how persistent malaria and hepatitis B are also associated with decreased packed cell volume (PCV) in pregnant women. [ABSTRACT FROM AUTHOR]

This study aimed to assess the prevalence of Staphylococcus aureus and Enterococcus sp. among pregnant women who visit the General Hospital in Delta Central Senatorial District, Nigeria. Samples were collected from the vaginal and rectum areas of pregnant women attending the General Hospitals of Abraka, Oghara, Udu, Ughelli North and Ughelli South. Bacteriological and biochemical analyses were conducted to isolate, characterize, and identify the bacteria. Two types of bacteria were found; Enterococcus sp. and Staphylococcus sp. The study result showed that Staphylococcus aureus (13.7%) was more prevalent than other isolates and was found in samples obtained from Udu General Hospital. In comparison, Ughelli South General Hospital had the lowest prevalence for S. aureus (7.9%). Samples from Oghara General Hospital had the highest prevalence for Enterococcus sp. (3.7%) while the lowest prevalence for Enterococcus sp. (1.1%) was obtained from Ughelli South General Hospital. S. aureus (51.6%) was found to be the most prevalent bacterium, while Enterococcus sp. (11.1%) was the least prevalent. The bacterial load from the vaginal swab samples was higher than that of rectum swab samples, which suggests that pregnant women attending these hospitals may have infections. The total bacterial count among pregnant women was highest in samples obtained from Udu General Hospital (5.4±0.5), followed by Abraka (5.0±0.6), Oghara (4.8±0.2), and Ughelli North (4.5±0.15), and while the least count was recorded from samples obtained from Ughelli South General Hospital (3.0±0.2). This study helps manage and plan future medical treatments. Pregnant women should be screened early in their pregnancies, between the 12th and 16th weeks, which is the second trimester, and treated appropriately to avoid complications that arise from untreated infections. [ABSTRACT FROM AUTHOR]

Background: Mother-to-child transmission (MTCT) accounts for 90% of all new paediatric HIV infections in Nigeria and for approximately 30% of the global burden. This study aimed to determine the effectiveness of a training model that incorporated case managers working closely with traditional birth attendants (TBAs) to ensure linkage to care for HIV-positive pregnant women. Methods: This study was a 3-arm parallel design cluster randomized controlled trial in Ifo and Ado-Odo Ota, Ogun State, Nigeria. The study employed a random sampling technique to allocate three distinct TBA associations as clusters. Cluster 1 received training exclusively; Cluster 2 underwent training in addition to the utilization of case managers, and Cluster 3 served as a control group. In total, 240 TBAs were enrolled in the study, with 80 participants in each of the intervention and control groups. and were followed up for a duration of 6 months. We employed a one-way analysis of variance (ANOVA) statistical test to evaluate the differences between baseline and endline HIV knowledge scores and PMTCT practices. Additionally, bivariate analysis using the chi-square test was used to investigate linkage to care. Furthermore, logistic regression analysis was utilized to identify TBA characteristics associated with various PMTCT interventions, including the receipt of HIV test results and repeat testing at term for HIV-negative pregnant women. The data analysis was performed using Stata version 16.1.877, and we considered results statistically significant when p values were less than 0.05. Results: At the end of this study, there were improvements in the TBAs' HIV and PMTCT-related knowledge within the intervention groups, however, it did not reach statistical significance (p > 0.05). The referral of pregnant clients for HIV testing was highest (93.5%) within cluster 2 TBAs, who received both PMTCT training and case manager support (p ≤ 0.001). The likelihood of HIV-negative pregnant women at term repeating an HIV test was approximately 4.1 times higher when referred by TBAs in cluster 1 (AOR = 4.14; 95% CI [2.82–5.99]) compared to those in the control group and 1.9 times in cluster 2 (AOR = 1.93; 95% CI [1.3–2.89]) compared to the control group. Additionally, older TBAs (OR = 1.62; 95% CI [1.26–2.1]) and TBAs with more years of experience in their practice (OR = 1.45; 95% CI [1.09–1.93]) were more likely to encourage retesting among HIV-negative women at term. Conclusions: The combination of case managers and PMTCT training was more effective than training alone for TBAs in facilitating the linkage to care of HIV-positive pregnant women, although this effect did not reach statistical significance. Larger-scale studies to further investigate the benefits of case manager support in facilitating the linkage to care for PMTCT of HIV are recommended. Trial registration: The study was retrospectively registered in the Pan African Clinical Trial Registry, and it was assigned the unique identification number PACTR202206622552114. [ABSTRACT FROM AUTHOR]

Background: Anaemia in pregnancy causes a significant burden of maternal morbidity and mortality in sub-Saharan Africa, with prevalence ranging from 25 to 45% in Nigeria. The main treatment, daily oral iron, is associated with suboptimal adherence and effectiveness. Among pregnant women with iron deficiency, which is a leading cause of anaemia (IDA), intravenous (IV) iron is an alternative treatment in moderate or severe cases. This qualitative study explored the acceptability of IV iron in the states of Kano and Lagos in Nigeria. Methods: We purposively sampled various stakeholders, including pregnant women, domestic decision-makers, and healthcare providers (HCPs) during the pre-intervention phase of a hybrid clinical trial (IVON trial) in 10 healthcare facilities across three levels of the health system. Semi-structured topic guides guided 12 focus group discussions (140 participants) and 29 key informant interviews. We used the theoretical framework of acceptability to conduct qualitative content analysis. Results: We identified three main themes and eight sub-themes that reflected the prospective acceptability of IV iron therapy. Generally, all stakeholders had a positive affective attitude towards IV iron based on its comparative advantages to oral iron. The HCPs noted the effectiveness of IV iron in its ability to evoke an immediate response and capacity to reduce anaemia-related complications. It was perceived as a suitable alternative to blood transfusion for specific individuals based on ethicality. However, to pregnant women and the HCPs, IV iron could present a higher opportunity cost than oral iron for the users and providers as it necessitates additional time to receive and administer it. To all stakeholder groups, leveraging the existing infrastructure to facilitate IV iron treatment will stimulate coherence and self-efficacy while strengthening the existing trust between pregnant women and HCPs can avert misconceptions. Finally, even though high out-of-pocket costs might make IV iron out of reach for poor women, the HCPs felt it can potentially prevent higher treatment fees from complications of IDA. Conclusions: IV iron has a potential to become the preferred treatment for iron-deficiency anaemia in pregnancy in Nigeria if proven effective. HCP training, optimisation of information and clinical care delivery during antenatal visits, uninterrupted supply of IV iron, and subsidies to offset higher costs need to be considered to improve its acceptability. Trial registration ISRCTN registry ISRCT N6348 4804. Registered on 10 December 2020 Clinicaltrials.gov NCT04976179. Registered on 26 July 2021 Plain language summary: Low blood level in pregnancy is of public health importance and with common occurrence worldwide, but with a higher rate in low resource settings where its burden greatly affects both the mother and her baby. This low blood level is usually caused by poor intake of an iron-rich diet. It could lead to fatigue, decreased work capacity, and dizziness if not detected. Without treatment, this condition could affect the baby, possibly leading to its sudden demise in the womb, immediately after birth, or even the woman's death. The use of oral iron has been the primary treatment; however, it is associated with significant side effects, which have led to poor compliance. Fortunately, an alternative therapy in the form of a drip has been shown to overcome these challenges. However, it is not routinely used in countries like Nigeria. Moreover, being effective is different from being utilised. Therefore, this study was conducted to understand the factors that will make this treatment widely accepted. We interviewed pregnant women, family support and health care providers in 10 health facilities in Lagos and Kano States, Nigeria. Our findings revealed good attitudes to iron drip. However, its inclusion into routine antenatal health talk, training of health care providers, availability of space, drugs and health workers who will provide this care, and ensuring this drug is of low cost are some of the efforts needed for this treatment to be accepted. [ABSTRACT FROM AUTHOR]

• Mother to child transmission of chikungunya virus (CHIKV) in Africa remains understudied. • 11.8% acute/recent CHIKV in 1006 pregnant women over three rainy seasons in Nigeria. • A total of 12 babies with CHIKV NT-confirmed mothers with four abnormal birth outcomes. • CHIKV infection during pregnancy in Nigeria deserves further studies. Chikungunya virus (CHIKV), a reemerging global public health concern, which causes acute febrile illness, rash, and arthralgia and may affect both mothers and infants during pregnancy. Mother-to-child transmission (MTCT) of CHIKV in Africa remains understudied. Our cohort study screened 1006 pregnant women with a Zika/dengue/CHIKV rapid test at two clinics in Nigeria between 2019 and 2022. Women who tested positive for the rapid test were followed through their pregnancy and their infants were observed for 6 months, with a subset tested by reverse transcription-polymerase chain reaction (RT-PCR) and neutralization, to investigate seropositivity rates and MTCT of CHIKV. Of the 1006, 119 tested positive for CHIKV immunoglobulin (Ig)M, of which 36 underwent detailed laboratory tests. While none of the IgM reactive samples were RT-PCR positive, 14 symptomatic pregnant women were confirmed by CHIKV neutralization test. Twelve babies were followed with eight normal and four abnormal outcomes, including stillbirth, cleft lip/palate with microcephaly, preterm delivery, polydactyly with sepsis, and jaundice. CHIKV IgM testing identified three possible antepartum transmissions. In Nigeria, we found significant CHIKV infection in pregnancy and possible CHIKV antepartum transmission associated with birth abnormalities. [ABSTRACT FROM AUTHOR]

Background: Anaemia during pregnancy causes adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth restriction. Iron deficiency anaemia (IDA) is the leading cause of anaemia and oral iron supplementation during pregnancy is widely recommended. However, little focus is directed to dietary intake. This study estimates the contribution of IDA among pregnant women and examines its risk factors (including dietary) in those with moderate or severe IDA in Lagos and Kano states, Nigeria. Methods: In this cross-sectional study, 11,582 women were screened for anaemia at 20-32 weeks gestation. The 872 who had moderate or severe anaemia (haemoglobin concentration < 10 g/dL) were included in this study. Iron deficiency was defined as serum ferritin level < 30 ng/mL. We described the sociodemographic and obstetric characteristics of the sample and their self-report of consumption of common food items. We conducted bivariate and multivariable logistic regression analysis to identify risk factors associated with IDA. Results: Iron deficiency was observed among 41% (95%CI: 38 – 45) of women with moderate or severe anaemia and the prevalence increased with gestational age. The odds for IDA reduces from aOR: 0.36 (95%CI: 0.13 – 0.98) among pregnant women who consume green leafy vegetables every 2-3 weeks, to 0.26 (95%CI: 0.09 – 0.73) among daily consumers, compared to those who do not eat it. Daily consumption of edible kaolin clay was associated with increased odds of having IDA compared to non-consumption, aOR 9.13 (95%CI: 3.27 – 25.48). Consumption of soybeans three to four times a week was associated with higher odds of IDA compared to non-consumption, aOR: 1.78 (95%CI: 1.12 – 2.82). Conclusion: About 4 in 10 women with moderate or severe anaemia during pregnancy had IDA. Our study provides evidence for the protective effect of green leafy vegetables against IDA while self-reported consumption of edible kaolin clay and soybeans appeared to increase the odds of having IDA during pregnancy. Health education on diet during pregnancy needs to be strengthened since this could potentially increase awareness and change behaviours that could reduce IDA among pregnant women with moderate or severe anaemia in Nigeria and other countries. [ABSTRACT FROM AUTHOR]

Introduction: The International Diabetes Federation has identified the emergence of gestational diabetes mellitus (DM) (GDM) as an underappreciated threat to maternal and child health. Adequate knowledge, a positive attitude towards prevention, and a positive perception of its danger could motivate pregnant women to take preventive measures. However, there is a dearth of literature on these among women attending antenatal clinics at UCH. This study, therefore aimed to assess pregnant women's knowledge about GDM, report their attitudes and determine their perception towards GDM. Methods: A cross-sectional study assessed the knowledge, attitude and perception towards GDM. A total of 300 pregnant women registered with and attending the antenatal clinic in University College Hospital (UCH), were selected using a random sampling technique. A self-structured questionnaire using a GDM Knowledge Questionnaire and previous research questions on Perception and Attitude was used to collect data from participants. Data were analysed using Statistical Package for Social Sciences 20.0 and hypotheses were tested using chi-square at 0.05 level of significance. Results: The mean age of the pregnant women was 30.60 ± 5.88 years. A little over one-fifth of the participants were knowledgeable about GDM. Three-quarters of the participants demonstrated a positive attitude while just a little over half had a positive perception of GDM. A significant association exists between participants' knowledge about GDM and belief about screening for diabetes during pregnancy (p =.006). There was a significant association between participants' attitude and their perception of GDM (p =.000). A direct significant association was also found between participants' knowledge and their perceived risk of developing GDM (p =.000). Discussion: While most of the pregnant women had poor knowledge about GDM, more than half of the pregnant women had positive attitudes towards GDM. A little over average possesses a positive perception towards GDM. Healthcare providers should intensify efforts in formulating appropriate methods to increase awareness with emphasis on the risks associated with GDM. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis B virus and human immunodeficiency virus (HBV/HIV) co-infection is a global health concern due to its significant impact on morbidity and mortality. Reports of HBV/HIV co-infections are increasing in Nigeria, but information on the disease burden in pregnant women and its implications on the fetus is scarce. This study aimed to determine the prevalence of HBV/HIV co-infection in pregnant women. In addition, the study identified the risk factors for the disease in pregnant women attending antenatal clinics in Osun State, Nigeria. Methodology: We collected plasma samples from 303 consenting pregnant women and used enzyme-linked immunosorbent assay (ELISA) to test for HBV (HBsAg) and HIV I/II antigens. We obtained demographic and risk factor data on HBV and HIV transmission using a structured questionnaire. Results: Our analysis revealed a prevalence of 3.96% for HBV/HIV co-infection in pregnant women. Bivariate analysis indicated a history of blood transfusion, oral or anal sex, and multiple sexual partners may be associated with an increased likelihood of HBV/HIV co-infection in pregnant women. After adjusting for other variables in multivariate analysis, none of these risk factors were significant at the 5% level. In contrast, formal education was a potential preventive factor in this population. Conclusions: Our study provides valuable information on the disease burden of HBV/HIV co-infection in pregnant women in Osun State, Nigeria, highlighting the importance of routine screening for HBV and HIV during antenatal care and emphasizing the importance of implementing preventive measures to reduce the morbidity and mortality associated with HBV/HIV co-infection. [ABSTRACT FROM AUTHOR]

Urinary tract infections (UTI) affect the structures involved in the secretion and elimination of urine. It is a common health concern and contributes about 13-33% of infection in pregnancy. The prevalence of UTI among pregnant women attending antenatal clinic in Iyi-Enu mission hospital and the sensitivity of isolates recovered, to antibiotics was studied. A total of 120 midstream urine samples collected from pregnant women who consented to the study, between January and March, 2023, were cultured on MacConkey agar, Blood agar and Cystine Electrolyte Deficient Agar. Isolates were identified using colony morphology, Gram stain reaction and biochemical tests. Susceptibility of the isolates to antibiotics was determined using Kirby- Bauer disc diffusion method. Results obtained from the structured questionnaire used for demographic data were statistically analyzed. The prevalence of UTI among pregnant women was 24.2%. The isolates recovered include; Escherichia coli (24.1%), Klebsiella spp. (18.5%), Proteus mirabilis (7.4%), Pseudomonas spp. (5.6%) and Staphylococcus aureus (44.4%). Gram negative bacteria were most susceptible to Cefuroxine (63%) and resistant to Ceftazidine (80.7%). Gram-positive isolates were susceptible to Levofloxacin (100%) but resistant to Amoxicillin (83.3%). Both Gram negative and Gram-positive organisms were recovered from UTI of pregnant women and were found to be sensitive to Cefuroxine and Levofloxacin respectively. There is need for proper diagnosis of UTI before treatment to avoid resistance of uropathogens to antibiotics. [ABSTRACT FROM AUTHOR]

Malaria parasite (MP) and human immunodeficiency virus (HIV) infections exist concomitantly in Nigeria. This study determined the prevalence of MP and HIV as they co-existed together using the data of pregnant women who came for antenatal visits at Ekiti State University Teaching Hospital, Ado-Ekiti between 2015 and 2016. The records of the pregnant women were obtained from the records of the hospital. The prevalence of MP among the pregnant women was 0.74% in 2015 and 0.51% in 2016 (P = 0.28) while that of HIV was 0.63% in 2015 and 1.84% in 2016 (P = 0.019). Since MP and HIV were observed in some of the patients indicate that MP and HIV exist among some pregnant women in Ekiti. Efforts to control these diseases should be intensified. [ABSTRACT FROM AUTHOR]

This paper examines how language is used to show shared beliefs between caregivers and pregnant women in antenatal classes in the Nigerian context, which hitherto suffers neglect. The data consist of tape recordings and observational notes taken during antenatal classes in selected hospitals in Lokoja, Nigeria. The study adopted a top-down analytic approach using Odebunmi's model of contextual beliefs, supported by van Dijk's epistemic context model, and Fetzer and Fischer's lexical markers model. The analysis shows three categories of shared knowledge: a. state of pregnancy and postnatal care b. sexual relationships and spice lexemes c. traditional child care and superstitions. Shared knowledge of the state of pregnancy and postnatal care manifests in pregnancy misconceptions, nutrition during pregnancy and postnatal care orientations highlighted by lexical markers such as recoverable knowledge connector and joint attention builder. Shared knowledge of sexual relations and spice lexemes reflect sexual communication and native spices using metaphorization and proximal deictic lexical markers. Grandmothers' involvement and insistence on using traditional methods and superstitions frame shared knowledge of traditional child care and superstitions through belief affirmative and self-reformulation markers. Analysis of the shared beliefs shows how caregivers represent pregnant women's mental knowledge in interactions as well as how pregnant women interject beliefs for clarification and validity. This way, both participants demonstrate how contextual beliefs facilitate communicative processes and meaningful understanding in their interactions. [ABSTRACT FROM AUTHOR]

A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability. What is already known on this subject? Psychiatric morbidity has immense effects on a woman's quality of life, social functioning, obstetric outcome, and economic productivity. What do the results of this study add? Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression. What are the implications of these findings for clinical practice and/or further research? Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability. [ABSTRACT FROM AUTHOR]

Kolanut contains caffeine and it is widely consumed in various social contexts in Nigeria and other Sub-Saharan African countries. While some studies have suggested that kolanut is consumed by pregnant women, there is a dearth of information on the prevalence, consumption pattern and reasons for kolanut consumption among this group. This study investigated kolanut use among pregnant women in Ibadan, Oyo State, Nigeria. A cross-sectional study involving 478 consenting pregnant women in all trimesters of pregnancy was conducted. Semi-structured questionnaires were used to collect data. Associations between kolanut use and respondent characteristics were investigated using the chi-square test and logistic regression analysis. The mean age of the women was 28.7 ± 6.3 years. One hundred and sixty-two (33.9%) of women reported kolanut use during pregnancy, 140 (29.3%) in the current pregnancy. Fifty-five (39.3%) pregnant women reported frequent use and 46 (32.9%) used it in high quantities. Significant associations were found between current kolanut use and Hausa respondents (p = 0.014), educational level; secondary (p = 0.032), tertiary (p = 0.006), TBA (p = 0.005). The majority (93.7%) used kolanut to prevent spitting, nausea, and vomiting. This study showed that kolanut use is quite common among pregnant women and frequently used in large quantities. [ABSTRACT FROM AUTHOR]

Introduction. Mother-to-child transmission remains an important mode of transmission of hepatitis B infection particularly in endemic areas. The knowledge and practices of pregnant women about mother-to-child transmission (MTCT) of hepatitis B virus (HBV) may influence the uptake of strategies to reduce mother-to-child transmission of infection. Objectives. This study assessed the knowledge and willingness to uptake hepatitis B virus infection preventive services among pregnant women in Ado-Ekiti, Nigeria. Methods. This was a cross-sectional study that involved 373 pregnant women at the Ekiti State University Teaching Hospital (EKSUTH) and Maternal Child Specialist Clinics, Ado-Ekiti, Nigeria. A structured questionnaire was used to assess their knowledge, practices, and perceptions about MTCT of hepatitis B infection. Results. Only 52.5% (196) of the respondents had good knowledge, although the majority 290 (77.7%) had heard of hepatitis B infection prior to the survey. Only 147 (39.4%) of the respondents had ever had hepatitis B screening. More persons with professional jobs had good knowledge about hepatitis B infection compared with other occupations (p < 0.001). However, more respondents aged 30–34 years had poor knowledge about hepatitis B infection compared with other age groups (p = 0.045). Respondents with good knowledge about hepatitis B infection were willing to uptake hepatitis B infection prevention services (p < 0.001) Conclusion. This study showed that respondents with professional jobs had good knowledge about hepatitis B infection and those who had good knowledge about the infection were willing to utilize hepatitis B preventive measures. Awareness of MTCT of HBV did not translate into good practice as only few respondents had screened for hepatitis B. There is a need to intensify education about modes of transmission of hepatitis B infection with an emphasis on promoting good preventive practices. [ABSTRACT FROM AUTHOR]

Across several African countries, birth preparedness and complication readiness (BPACR) among pregnant women is poor. The practice of BPACR, though improving in recent years, is not commensurate with the knowledge available to pregnant women. Maternal health indices remain sub-optimal. This study evaluates the determinants of this "know-do' gap among women receiving antenatal care at a secondary health facility in Benin City, Nigeria. A cross-sectional study involving 427 pregnant women was conducted between October and December 2020 using a structured interviewer-administered questionnaire. The prevalence of knowledge and practice were described, and the determinants of BPACR practice evaluated using bivariable (chi-square) analysis and multivariable ordinal logistic regression with post-estimation predictive margins analysis. About 77% of respondents had good birth preparedness practice. Multivariable regression revealed that respondents with poor knowledge and moderate knowledge of components of BPACR had statistically significant lower odds (OR:0.05 (95% CI: 0.02-0.13) and 0.10 (95% CI: 0.03-0.30) times, respectively) for greater practice of BPACR when compared to those with good knowledge. Respondents with poor knowledge of danger signs had statistically significant lower odds (OR: 0.08 (95% CI: 0.03-0.26) for greater practice of BPACR when compared to those with good knowledge. But predictive margins analyses demonstrates that knowledge, though critical to practice, is insufficient to optimize practice. The optimum number of danger signs women need to know to improve practice may be between eight to ten. Beyond this number, practice may not change significantly. Other predictors of BPACR practice include income level, parity, gravidity, and residential settings. The number of antenatal clinic visits had no statistically significant correlation with BPACR practice. Interventions to facilitate practice at the community level may be helpful to improve outcomes and bridge the know-do gap with respect to BPACR within the study context. [ABSTRACT FROM AUTHOR]

The authors assessed the knowledge of obstetric danger signs and its determinants among 405 pregnant women in their 3rd trimester receiving antenatal care. The study was cross-sectional. Those knowledgeable of danger signs during pregnancy were 24.9%, labor 29.9%, postpartum 15.6% and in the new-born 36.0%. There were associations between age, higher level of education, gestational age and social class and knowledge of obstetric danger signs. Our findings suggest the need to increase the awareness of obstetric danger signs through provision of information, education, and empower the family. [ABSTRACT FROM AUTHOR]

This study was targeted at assessing malaria prevalence, clinical symptoms and urine abnormalities associated with malaria in pregnancy. A cross-sectional study involving 250 pregnant women selected from five healthcare facilities in three local government areas of Abia state, was conducted. Data were collected using pre-tested structured questionnaires and patients' blood and urine samples collected. Thick and thin blood films microscopy as well as malaria random kits were used to diagnose malaria. Medi-test combi 9 urine test strip was used to check urine abnormalities. Data were analysed using SPSS version 26. An overall malaria prevalence of 56% (95% CI: 0.42-0.60) was observed. Of the five centres, the highest prevalence was reported at PHC III in Umuahia North LGA with prevalence at 72% (95% CI: 0.51-0.98), while the lowest was reported at PHC IV in Umuahia North LGA with a prevalence of 36% (95% CI: 0.21-0.49). Pregnant women who had headache (OR=3.316, p=0.009, 95% CI: 1.288-7. 400), catarrh (OR=3.972, p=0.032, 95% CI: 1.028-15.352) and fever (OR=9.459, p<0.001, 95% CI: 3.767-23.753) had higher odds of malaria infection, compared to those without headache, catarrh and fever. Malaria was largely recorded among the primigravids 71% (53/75), followed by the secundigravidae 61% (43/70) and the least, observed among the multigravidae 43% (45/105). High malaria prevalence was observed among subjects who did not use preventive measures (100%) with the least observed among subjects, using window nets (22%). Malaria among subjects in this study is significantly prevalent. Proteinuria, bilirubinuria, urobilinogenuria as well as amber and clear urine macroscopy showed significant associations with malaria in pregnancy; thus, women with these clinical features should be further tested for malaria even in asymptomatic states to prevent the negative consequences of malaria in pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: rubella is a leading cause of vaccine preventable birth defects especially in developing countries. Acquisition of infection with the rubella virus in early pregnancy exposes the fetus to a very high chance of developing congenital rubella syndrome. The neonate is born with multiple abnormalities with the triad of congenital cataract, deafness and cardiovascular abnormalities like ventricular septal defect or patent ductus arteriosus. Limited data exist on the seroprevalence of rubella antibodies in pregnant women in Nigeria. The aim of this study was to determine the seroprevalence of rubella antibodies in pregnant women attending antenatal clinic in Aminu Kano Teaching Hospital, Kano State. Methods: the study was a cross-sectional study involving one hundred and sixty-three pregnant women attending antenatal clinic of Aminu Kano Teaching Hospital in Kano, Nigeria. Interviewer administered questionnaire was used to collect sociodemographic data and risk factors. Blood samples were taken from consenting pregnant women during antenatal care and samples were subjected to antibody testing (IgG and IgM). Descriptive analysis was done for sociodemographic data and seroprevalence of rubella. Chi-square tests were used to determine associations. Results: one hundred and sixty-three pregnant women were recruited for the study. The participants' age ranged from 18 to 41 years with mean age of 27.60±5.7 years. The overall rubella seroprevalence was found to be 68.7%. The seroprevalence of specific anti-Rubella virus IgM and IgG was found to be 58.4% and 37.3% respectively while prevalence of having both anti-Rubella virus IgG and IgM in the women was found to be 26.4%. Non-formal education and immunodeficiency was found to be associated with rubella infection (P-value of 0.018 and 0.001 respectively). Conclusion: the study found a high prevalence of anti-Rubella virus immunoglobulins in asymptomatic pregnant women attending antenatal care in our facility with immunodeficiency and non-formal education found to be significant risk factors. [ABSTRACT FROM AUTHOR]

Background: Maternal health is the mother's state of well being before, during, and after conception. Studies have suggested that the increasing maternal mortality rate is preventable provided maternal health services are accessible during pregnancy. This study explored the association between socioeconomic status and the utilization of maternal health services in the Federal Medical Centre (FMC), Abeokuta, Ogun State. Materials and Methods: This study is a cross sectional survey. One hundred and eighty eight pregnant women from the antenatal unit of a tertiary hospital in Southwestern Nigeria were selected using a convenience sampling technique. Data were collected via a pretested, self designed questionnaire. The descriptive statistics were used to analyze the resulting data, and the hypotheses were tested using the Pearson product moment correlation at 0.05 level of significance. Result: From the study, 72 (38.30%) and 58 (30.90%) agreed that their income and occupation influence their maternal health services utilization. Significant relationship (p < 0.05) existed between maternal health service utilization and age and between socioeconomic factors (occupation and income level) and utilization of maternal health services of pregnant women. Conclusions: Overall, this study revealed that the level of utilization of maternal health services among expectant women attending FMC is moderate. As this study has shown that socioeconomic factors influence the utilization of maternal health services, we recommend that interventions by health workers targeted at improving the utilization of maternal health services should consider these factors when designing such interventions. It is hoped that this will contribute to reducing maternal mortality and morbidity in this state. [ABSTRACT FROM AUTHOR]

Background: Pregnancy-related acute kidney injury (PRAKI) is a common cause of AKI globally. The incidence and burden of PRAKI are still high in low and middle-income countries (LMICs) especially in Africa due to limited access to optimal obstetric care, late diagnosis, and referral. The study aimed to determine the incidence and aetiologies of PRAKI among women in the peripartum period in two government hospitals in Nigeria. Methodology: This was a prospective study where serum creatinine was measured among pregnant women presenting in labour at 0-hour, 6 hour, 12 hour, 24 hour, 48 hour and 7 days post-delivery. AKI was defined using the Kidney Disease Improving Global Outcome criteria. Binary logistic regression was used to determine predictors of PRAKI. Results: The mean age of the 162 pregnant women who completed the study was 30.05±1.28 years. The incidence of AKI use was 22.2%. The aetiologies of PRAKI were obstetric haemorrhage (66.7%), eclampsia (19.4%), and sepsis (13.9%). Seventeen (47.2%) patients had Stage 1 PRAKI, 12 (33.3%) had Stage 2 PRAKI, while seven (19.4%) had Stage 3 PRAKI. Factors significantly associated with PRAKI were parity (p=<0.001), caesarean section (p=<0.001), excess blood loss (p=<0.001), and prolonged duration of labour (p=0.002). Conclusion: PRAKI occurred in 1 out 5 pregnant women in the peripartum period. Obstetric haemorrhage, sepsis, and eclampsia which are preventable or treatable are common major aetiologies of PRAKI. PRAKI is more associated with multi-parity, caesarean delivery, haemorrhage, and prolonged duration of labour. Optimal ante-natal care, health education, and prompt diagnosis and management of obstetric complications will reduce the incidence in Nigeria. [ABSTRACT FROM AUTHOR]

Women have distinct nutritional requirements, especially before, during pregnancy and while breastfeeding. Avoiding certain foods during pregnancy for any reasons devoid of scientific proofs adversely affects maternal nutritional needs. This study explored foods avoidance in pregnancy and related reasons among pregnant women in Ebonyi state. The study adopted a descriptive survey research design. Population was made up of pregnant mothers attending antenatal clinics in the health care facilities in Ebonyi state. Questionnaire was used for data collection. Data were analyzed using percentages, rank order, means and standard deviation. Results include 25 avoided foods by pregnant women in Ebonyi state. Those with the high avoidance percentage scores are squirrels (59.1%), bird gizzard (59.1%), snails (55.50%), frogs (55.2) and others. Other findings are four strongest reasons for avoiding foods, namely, snails in pregnancy because my baby would be sluggish and spit too much saliva (X̅ =2.53), bird gizzard (eke-okuko)/ meat liver (mejiu – anu) during pregnancy because it is against my culture and can prolong labour and delivery difficulties (X̅ = 3.06), okra soup in pregnancy because my baby spit too much saliva after birth (X̅ = 3.01), and snails were avoided in pregnancy becauset it is against my culture (X̅ =3.12). There are also six weak reasons for avoidance of food. These are egg during pregnancy because it will make my baby a thief (X̅ =2.13), male organ of an animal during pregnancy because it is a taboo in my community (X̅ =2.02), vegetables like cabbage and avocado during pregnancy to avoid fatty baby which is difficult to deliver (X̅ =1.67) and others. The study recommended the need for nutritional education programme and sensitization campaign by the relevant stakeholders/health educators to address foods avoidance in pregnancy and its reasons, especially during antenatal care services. [ABSTRACT FROM AUTHOR]

Background: Gestational weight gain (GWG) is a risk factor for adverse pregnancy outcomes, future obesity and chronic diseases among women. However, has not received much attention in many low and middle-income countries such as Nigeria. We investigated the pattern, associated factors and pregnancy outcomes of GWG in Ibadan, Nigeria, using the Ibadan Pregnancy Cohort Study (IbPCS). Methodology: The IbPCS is a multicentre prospective cohort study conducted among 1745 pregnant women recruited from four health facilities in Ibadan, Nigeria. GWG, the primary outcome, was categorised according to the Institute of Medicine's classification into insufficient, adequate and excessive weight gain. Pregnancy outcomes were the secondary outcome variables. Logistic regression analysis (Adjusted odds ratios and 95% confidence interval CI) was used to examine associations, and Poisson regression analyses were used to investigate associations with outcomes. Results: Only 16.9% of women had optimal GWG, 56.8% had excessive GWG, and 26.9% had insufficient GWG. Excessive GWG was associated with high income '> #20,000-' (AOR: 1.64, 95% CI: 1.25–2.17), being overweight (AOR: 2.12, 95% CI: 1.52–2.95) and obese (AOR: 1.47, 95% CI: 1.02–2.13) after adjusting for confounders. In contrast, increased odds of insufficient GWG have associated women with depression (AOR: 1.70, 95% CI 1.17–2.47). There was no significant association between inappropriate GWG and pregnancy outcomes However, there was an increased odds for postpartum haemorrhage (AOR: 2.44, 95% CI 1.14–5.22) among women with obesity and excessive GWG. Conclusions: Excessive GWG was the most typical form of GWG among our study participants and was associated with high maternal income, and being overweight or obese. GWG needs to be monitored during antenatal care, and interventions that promote appropriate GWG should be implemented among pregnant women in Nigeria. [ABSTRACT FROM AUTHOR]

Background: The most recent WHO guideline on antenatal care (ANC) utilization reaffirmed the necessary and compulsory care and services a pregnant woman should receive to maximize the importance and gains of ANC. While most studies focused on the time of initiation and number of ANC contacts, emphasis was rarely placed on the components of ANC offered to women. This study assessed how complete the components of ANC received by pregnant women are as a proxy for the quality of ANC services offered in Nigeria. We also assessed the clustering of the components and state-level differentials and inequalities in the components of ANC received in Nigeria. Methods: We used nationally representative cross-sectional data from the 2018 Nigeria Demographic Health Survey. We analysed the data of 11,867 women who had at least one ANC contact during the most recent pregnancy within five years preceding the survey. The assessed components were tetanus injection, blood pressure, urine test, blood test, iron supplement, malaria intermittent preventive treatment in pregnancy (IPTp), and told about danger signs. Others are intestinal parasite drugs (IPD)intermittent and HIV/PMTCT counsel. Descriptive statistics, bivariable and multivariable multilevel Bayesian Monte Carlo Poisson models were used. Results: In all, 94% had blood pressure measured, 91% received tetanus injection, had iron supplement-89%, blood test-87%, urine test-86%, IPTp-24%, danger signs-80%, HIV/PMTC-82% and IPD-22%. The overall prevalence of receiving all 9 components was 5% and highest in Ogun (24%) and lowest in Kebbi state (0.1%). The earlier the initiation of ANC, the higher the number of contacts, and the higher the quality of ANC received. Respondents with higher education have a 4% (adjusted incidence risk ratio (aIRR): 1.04, 95% credible interval (CrI): 1.01–1.09) higher risk of receiving more components of ANC relative to those with no education. The risk of receiving more ANC components was 5% (aIRRR: 1.05, 95% CI: 1.01–1.10) higher among pregnant women aged 40 to 49 years than those aged 15 to 19 years. Women who decide their healthcare utilization alone had a 2% higher risk of getting more components than those whose spouses are the only decision taker of healthcare use. Other significant factors were household wealth status, spouse education, ethnicity, place of ANC, and skill of ANC provider. Pregnant women who had their blood pressure measured were very likely to have blood and urine tests, tetanus injections, iron supplements, and HIV talks. Conclusions: Only one in every 20 pregnant women received all the 9 ANC components with wide disparities and inequalities across the background characteristics and the States of residence in Nigeria. There is a need to ensure that all pregnant women receive adequate components. Stakeholders should increase supplies, train, and create awareness among ANC providers and pregnant women in particular. [ABSTRACT FROM AUTHOR]

Background: High maternal mortality has been associated with inadequate Birth preparedness and Complication Readiness (BPCR) and non-institutional delivery in developing countries. Therefore, there is a need for proven interventions that will improve BPCR and institutional delivery to reduce maternal mortality. Therefore, this study evaluated the effects of Goal-Oriented Prenatal Education (GOPE) on pregnant women's BPCR and institutional delivery. Methods: The study adopted a quasi-experimental two-group pre and post-test design. Two Local Government Areas (LGAs) were randomly selected from the six semi-urban LGAs in Ibadan. These LGAs were randomized into an intervention and control group. Two Primary Healthcare Centres (PHCs) were randomly selected from each LGA, and 400 pregnant women who registered for antenatal care in the selected PHCs, and met the inclusion criteria were purposively selected to participate in the study. A validated questionnaire and checklist were adapted for data collection at baseline and post-intervention. The pregnant women in the intervention group received GOPE focusing on knowledge and attitude to BPCR. Participants' place of birth was documented at delivery. Data were analyzed using descriptive statistics, and the Mann-Whitney U test at α0.05. Results: Good knowledge of BPCR was found in 65.5% of pregnant women at baseline and 91.8% post-intervention. Good BPCR practice was found in 95.3% and 73.1% of women in the intervention and control groups respectively. At delivery, 93.5% and 53.5% had institutional delivery in the intervention and control groups respectively. A significant difference (p<0.001) was observed in BPCR knowledge and attitude post-intervention, as well as in BPCR practice and institutional delivery between women in the intervention and control group. Conclusions: Goal-oriented prenatal education improved birth preparedness and complication readiness as well as institutional delivery among pregnant women. This should be integrated into routine prenatal education in Nigeria. [ABSTRACT FROM AUTHOR]

Background: Feminist scholarship is acutely aware that health is not dependent on behavioural choices alone but on interlocking social determinants that affect people's capacity to lead healthy lives. Women are situated within social structures that impact their health. but there is limited engagement with interpretive tools such as feminist theories that centre the realities of African women, particularly in the context of maternal health. It is imperative that women's control over their reproductive health and autonomy in seeking care, particularly skilled maternal healthcare are understood within this context. This study seeks to examine pregnant women's socio-cultural realities in a Nigerian context and in congruence with articulations of African feminism. Feminist scholarship acknowledges that women are situated within social structures that impact their health. Therefore, this paper seeks to examine pregnant women's socio-cultural realities in a Nigerian context and in congruence with articulations of African feminism. Method: This is a cross-sectional qualitative study of a total of 64 participants: 39 women and 25 men in Ewato and Okpekpe communities, two Local Government Areas of Edo State in southern Nigeria. The study presents findings from eight sex-and-age desegregated focus group discussions. This study reports on emergent data related to women's decision-making in accessing skilled maternal care. Data were transcribed and translated to English. Using the NVivo 1.6 software, data were coded and analyzed using a conventional approach to content analysis. Results: Findings describe ways in which women negotiate authority by ascribing the role of decision-maker to their men spouses while maintaining influence over their pregnancy healthcare decisions and actions. Negofeminism's concepts of alliance, community and connectedness were highlighted through men's constructive involvement in maternal health. Furthermore, women were shown to maneuver patriarchal norms to gain control of their healthcare decisions. Conclusion: This study offers a different narrative from the dominant view of non-Western women, specifically African women, as oppressed passive victims who are ineffectual in taking charge of their health. From the perspective of negofeminism, women navigate patriarchal environments to yield the best possible maternal health outcomes. The current study can be useful in informing policy and programming that acknowledges women's social embeddedness. [ABSTRACT FROM AUTHOR]