Perception of male gender preference among pregnant igbo women

Preference and Disclosure of Fetal Gender to Pregnant Women during Prenatal Ultrasonography in South South Nigeria

BACKGROUND

Ultrasound scan (USS) in pregnancy has become a common diagnostic tool used in the assessment of pregnancy in recent time. In the course of routine pregnancy assessment using USS, some pregnant women will request to know the sex of their unborn babies. Their reasons for wanting to know the gender of their baby could be either for social reason like planning for an unborn child or their desire for a preferred gender.

AIM

The aim of the study was to evaluate gender preferences and disclosure of foetal sex at prenatal USS.

METHODS

This was a cross-sectional study conducted at the antenatal clinic of Central Hospital Agbor, Delta State, Nigeria. A total of 235 consecutive consenting women who came for antenatal care (ANC) registration were recruited for the study after obtaining their informed written consent. Questionnaire was used to seek for their sociodemographic characteristics, preference and desires for foetal gender disclosure, reasons for gender disclosure, and awareness of USS accuracy for gender determination.

RESULTS

The desire to know the sex of baby was high (99.6%). The major reason for wanting to know the sex of baby was to plan for the unborn child (47.7%) and maternal curiosity (37.0%). Majority of the women (57.4%) had no gender preference. Sixty percent (60%) were not aware that USS sex diagnosis could be wrong.

CONCLUSION

There is a strong desire by pregnant women to know the sex of their babies at routine USS. Considering the fact that many of the women were not aware that there could be wrong diagnosis at prenatal ultrasound, it is suggested that adequate counselling be given before fetal sex disclosure.

Ultrasound imaging and the culture of pregnancy management in low-and middle-income countries: A systematic review

BACKGROUND

Obstetric ultrasound imaging is a relatively new, but rapidly expanding, technology in low- and middle-income countries (LMICs). Given that new technologies modify practices, the influence of ultrasound on pregnancy management in LMICs is not comprehensively understood.

OBJECTIVES

To map how ultrasound technology may be modulating the culture of pregnancy management in LMICs.

SEARCH STRATEGY

A search of five databases up to November 18, 2022.

SELECTION CRITERIA

Original, peer-reviewed articles from LMICs, published in English from 2000 to 2022.

DATA COLLECTION AND ANALYSIS

All articles were assessed for quality using the GRADE approach. Data were analyzed thematically to generate new interpretive constructs and explanations.

RESULTS

Forty articles involving 113 000 respondents suggests that obstetric ultrasound is becoming the preferred method of pregnancy surveillance, replacing clinically important components of prenatal care. Mothers overestimate ultrasound as an all-powerful diagnostic and "therapeutic" tool that can deliver the perfect baby. For-profit providers are driving medically unnecessary scans while the poor do not receive the recommended scans.

CONCLUSION

Ultrasound technology has modified the culture of pregnancy management in LMICs in unintended and possibly harmful ways. Private health services are pushing the detrimental trends. Limitations include generalizability of qualitative studies and insufficient attention to inequities.

The magnitude and determinants of depressive symptoms amongst women in early pregnancy in Southern Nigeria: A cross-sectional study

Background

Antenatal depression (AD) is prevalent and associated with adverse pregnancy, maternal and child outcomes, yet no study has addressed its magnitude and predictors in early pregnancy in Nigeria.

Aim

To determine the prevalence and factors associated with AD in first half of pregnancy.

Setting

Multicentric health facilities in Southern Nigeria.

Methods

A multicentric health-facilities-based cross-sectional study was conducted from January to July 2018. Using pretested structure interviewer-administered questionnaires, antenatal depressive symptoms were assessed amongst 511 pregnant mothers with the Edinburg Postnatal Depressive Scale tool. Socio-demographic, socio-economic, clinical, family and social factors were also measured. Descriptive statistics, bivariate and multivariable logistic regression analyses were employed to describe and identify factors associated with AD.

Results

The prevalence of antenatal depressive symptoms in early pregnancy in this study was 29.4% (95% confidence interval [CI] 26.6–32.9). Factors independently associated with AD were intimate partner violence (adjusted odds ratios [AOR] = 8.10, 95% CI 5.00–13.14), marital dissatisfaction (AOR 5.48, 95% CI 3.48–8.38), poor social support (AOR 4.70; 95% CI 2.99–7.38), past history of depression (AOR 4.67; 95% CI 2.47–8.80), previous pregnancy complication (AOR 2.50, 95% CI 1.57–3.89), low socio-economic status (AOR 2.41, 95% CI 1.61–3.66) and unplanned pregnancy (AOR 2.35, 95% CI 1.47–3.64).

Conclusions

The prevalence of antenatal depression is high with modifiable risk factors requiring context-specific policies such as provision of family, social and economic support for mothers at the earliest possible contact in the antenatal period.

Changing patterns of gender inequities in childhood mortalities during the Sustainable Development Goals era in Nigeria: findings from an artificial neural network analysis

OBJECTIVES

In line with the child survival and gender equality targets of Sustainable Development Goals (SDG) 3 and 5, we aimed to: (1) estimate the age and sex-specific mortality trends in child-related SDG indicators (ie, neonatal mortality rate (NMR) and under-five mortality rate (U5MR)) over the 1960s-2017 period, and (2) estimate the expected annual reduction rates needed to achieve the SDG-3 targets by projecting rates from 2018 to 2030.

DESIGN

Group method of data handling-type artificial neural network (GMDH-type ANN) time series.

METHODS

This study used an artificial intelligence time series (GMDH-type ANN) to forecast age-specific childhood mortality rates (neonatal and under-five) and sex-specific U5MR from 2018 to 2030. The data sets were the yearly historical mortality rates between 1960s and 2017, obtained from the World Bank website. Two scenarios of mortality trajectories were simulated: (1) status quo scenarios-assuming the current trend continues; and (2) acceleration scenarios-consistent with the SDG targets.

RESULTS

At the projected rates of decline of 2.0% for NMR and 1.2% for U5MR, Nigeria will not achieve the child survival SDG targets by 2030. Unexpectedly, U5MR will begin to increase by 2028. To put Nigeria back on track, annual reduction rates of 7.8% for NMR and 10.7% for U5MR are required. Also, female U5MR is decreasing more slowly than male U5MR. At the end of SDG era, female deaths will be higher than male deaths (80.9 vs 62.6 deaths per 1000 live births).

CONCLUSION

Nigeria is not likely to achieve SDG targets for child survival and gender equities because female disadvantages will worsen. A plausible reason for the projected increase in female mortality is societal discrimination and victimisation faced by female child. Stakeholders in Nigeria need to adequately plan for child health to achieve SDG targets by 2030. Addressing gender inequities in childhood mortality in Nigeria would require gender-sensitive policies and community mobilisation against gender-based discrimination towards female child.

Do pregnant women want to know the sex of the expected child at routine ultrasound and are they interested in sex selection?

BACKGROUND

The aim of the study was to investigate if expecting parents wanted to know the sex of the fetus during ultrasound examination and if they had discussed it with the midwife. Another aim was to explore any interest in sex selection.

METHODS

A longitudinal survey in early and late pregnancy among 2393 women in Sweden.

RESULTS

Almost all (95.8%, n = 2289) women had discussed sex determination with the partner before the ultrasound scan, and 57% (n = 1356) of women and their partners wanted to find out the fetal sex. The expecting parents mostly initiated a discussion with the midwife (46%, n = 1088), but 10% (n = 229) stated that the midwives initiated the discussion. Few (5%, n = 118) expressed a potential interest in selecting sex of a baby. Women who were interested in sex determination did not differ from those who were not, with respect to age, origin, education, parity, level of pregnancy planning, or importance of religion, but women who had chosen another fetal diagnostic method were more interested in sex determination and in potential sex selection.

CONCLUSIONS

Half of women and their partners wanted to know the fetal sex, and 5% were interested in sex selection. This high interest in sex determination is a challenge, since present national guidelines do not include sex determination as an option.

Immunization in pregnancy clinical research in low- and middle-income countries - Study design, regulatory and safety considerations

Immunization of pregnant women is a promising public health strategy to reduce morbidity and mortality among both the mothers and their infants. Establishing safety and efficacy of vaccines generally uses a hybrid design between a conventional interventional study and an observational study that requires enrolling thousands of study participants to detect an unknown number of uncommon events. Historically, enrollment of pregnant women in clinical research studies encountered many barriers based on risk aversion, lack of knowledge, and regulatory ambiguity. Conducting research enrolling pregnant women in low- and middle-income countries can have additional factors to address such as limited availability of baseline epidemiologic data on disease burden and maternal and neonatal outcomes during and after pregnancy; challenges in recruiting and retaining pregnant women in research studies, variability in applying and interpreting assessment methods, and variability in locally acceptable and available infrastructure. Some measures to address these challenges include adjustment of study design, tailoring recruitment, consent process, retention strategies, operational and logistical processes, and the use of definitions and data collection methods that will align with efforts globally.

Desire for prenatal gender disclosure among primigravidae in Enugu, Nigeria

BACKGROUND

Prenatal gender disclosure is a nonmedical fetal ultrasonography view, which is considered ethically unjustified but has continued to grow in demand due to pregnant women's requests.

OBJECTIVE

The aim of this study was to determine the proportion of primigravidae who want prenatal gender disclosure and the reasons for it.

METHODS

This was a descriptive cross-sectional study of randomly selected primigravidae seen at Enugu Scan Centre. The women were randomly selected using a table of random numbers.

RESULTS

Ninety percent (225/250) of 250 primigravidae who fulfilled the criteria for inclusion in this study wanted to know the gender of their unborn baby, while 10% (25/250) declined gender disclosure. Furthermore, 62% (155/250) of primigravidae had preference for male children. There was statistically significant desire for male gender (P=0.0001). Statistically significant number of primigravidae who wanted gender disclosure did so to plan for the new baby (P=0.0001), and those that declined gender disclosure "leave it to the will of GOD" (P=0.014).

CONCLUSION

Ninety percent of primigravidae wanted gender disclosure because of plans for the new baby, personal curiosity, partner and in-laws' curiosity; moreover, some women wanted to test the accuracy of the findings at delivery and 62% of primigravidae had preference for male children. In view of these results, gender disclosure could be beneficial in this environment.