Impact of Parity on Cardiac Structure and Function in Apparently Healthy Pregnant Nigerian Women

BACKGROUND

There are few and conflicting reports in the literature about the relationship between parity and maternal cardiac function. The study aimed to assess the impact of parity on cardiac structure and function in apparently healthy pregnant women in Nigeria.

METHODS

This was a cross-sectional study carried out in 3 tertiary centers in Kano, and 1 in Ile-Ife, Nigeria. 112 apparently healthy pregnant women were consecutively recruited between the 28th and 38th weeks of gestation, and their cardiac structure and function assessed using echocardiography. Left ventricular (LV) systolic dysfunction was defined as LV ejection fraction of below 50%, and diastolic dysfunction was graded using mitral filling and tissue Doppler velocities.

RESULTS

LV systolic dysfunction and diastolic dysfunction were found in 6 (5.4%) subjects and 20 (17.9%) subjects, respectively. Age (p= <0.0001), left atrial (LA) size (P<0.0001), interventricular septal thickness at end diastole (IVSD) (p= 0.005), posterior wall thickness at end diastole (PWTD) (p=0.004) and QRS duration (p= <0.0001) all increased progressively with higher parity, while tricuspid annular systolic excursion (p=0.320) decreased with higher parity. There was significant positive correlation between parity and age (r= 0.475, p= <0.0001), LA size (r=0.332, p= <0.0001), IVSD (r=0.264, p= 0.005) and PWTD (r= 0.343, p= <0.0001). LV systolic function was not significantly associated with parity.

CONCLUSION

Our findings suggested that parity was significantly associated with myocardial remodeling in apparently healthy pregnant women.

Impact of parity on cardiac structure and function in apparently healthy pregnant women in Nigeria

Background

There are a few and conflicting data in the literature about parity and maternal cardiac function.

Purpose

The purpose of this study was to assess the impact of parity on cardiac structure and function in apparently healthy pregnant women in Nigeria.

Methods

This was a cross-sectional study carried out in 4 tertiary centers in Kano, and 1 in Ile- Ife, Nigeria. 112 apparently healthy pregnant women were consecutively recruited between 28thand 38th weeks of gestation. Left ventricular (LV)systolic dysfunction was defined as LV ejection fraction of below 50%, and diastolic dysfunction was graded using mitral filling pattern and tissue velocities.

Results

LV systolic dysfunction and diastolic dysfunction were found in 6 (5.4%) subjects and 20 (17.9%) subjects respectively. Age (p= &lt;0.0001), left atrial (LA)size (P= &lt;0.0001), interventricular septal thickness at end diastole (IVSD) (p=0.005) and posterior wall thickness at end diastole (PWTD) (p=0.004) increased progressively with parity (Table 1). There was significant positive correlation between parity and age (r=0.475, p= &lt;0.0001), LA size (r=0.332, p= &lt;0.0001), IVSD (r=0.264, p=0.005) and PWD (r=0.343, p= &lt;0.0001). LV systolic function was not significantly associated with parity.

Conclusion

Our findings suggests that parity causes significant myocardial remodeling in apparently healthy pregnant women that should be taken in to consideration while interpreting their echocardiograms.

Funding Acknowledgement

Type of funding sources: None.

Knowledge, attitude, and practice of diabetic retinopathy among physicians in Northwestern Nigeria

Background

Diabetic retinopathy (DR) is the leading cause of preventable blindness in the productive population that poses a considerable global public health burden.

Objective

The objective of this study is to assess the knowledge, attitude, and practice of DR screening among physicians in Northwestern Nigeria. Materials and Methods: Survey responses were obtained from 105 physicians in 4 tertiary hospitals using a Likert scale questionnaire. The internal consistency of the questionnaire was calculated using Cronbach's alpha coefficient. Principal component analysis was used for data reduction and grouping with the varimax rotation method, and the factors were extracted based on an Eigenvalue> 1.

Results

Most of the respondents (78.8%) were aware of the most effective method of delaying the onset of DR and frequency of eye examination (94.1%). Lack of ophthalmoscopes (70.6%) and dilating eye drops (50.6%) form important barriers to performing a good eye examination.

Conclusion

DR screening among physicians practicing in Northwestern Nigeria was suboptimal, which prompts the need for improved training of physicians managing persons with diabetes on eye examination in a bid to strengthen DR screening and reduce the burden of visual impairment in our environment.