Evaluation of anxiety and depression among pregnant women in Enugu, Nigeria

Background

Maternal depression and anxiety during pregnancy are public health concerns. They are commonly reported among pregnant women from all over the world. Maternal mental health has not been prioritized, especially in low- and middle-income countries.

Aim

To evaluate depression and anxiety among pregnant women who receive antenatal care in four randomly selected hospitals in Enugu, Nigeria.

Materials and Methods

A multicenter questionnaire-based cross-sectional survey of 434 pregnant women was conducted at four selected health institutions offering antenatal services in Enugu, Enugu State. The prevalence of anxiety and depression was assessed using the hospital anxiety and depression scale (HADS). Factors associated with anxiety and depression were determined using logistic regression. P <0.05 was taken as significant.

Results

The mean age of study participants was 30.09 ± 5.12 years. The proportion of participants with depressive symptoms and borderline depressive symptoms was 9.7% and 11.1%, respectively. The proportion of participants with anxiety symptoms and borderline anxiety symptoms was 10.1% and 15.7%, respectively. Husband's employment status (P = 0.033, odds ratios (OR) =0.354, 95% confidence intervals (CI) =0.137-0.918) and gestational age (P = 0.042, OR = 2.066, 95% CI = 1.028-4.151) were the only factors associated with depressive symptoms, while only educational level (P = 0.001, OR = 3.552, 95% CI = 1.674-7.537) and husband's employment status (P = 0.013, OR = 0.295, 95% CI = 0.113-0.772) were the only factors associated with anxiety symptoms.

Conclusions

Anxiety and depressive symptoms are relatively common in antenatal women in Enugu. The factors associated with depressive and anxiety symptoms were the respondent's educational level, gestational age, and the employment status of the husband.

Effect of late antenatal booking on maternal anemia and fetus birth weight on parturients in Enugu, Nigeria: An analytical cross-sectional study

Background

The benefits of antenatal care are maximized when women book early for care. However, despite these resounding benefits, women still book late, while others do not book at all, resulting in dire feto-maternal consequences.

Aim

Determine the effect of late prenatal booking on maternal anemia and birth weight in babies of women who delivered in public health facilities in Enugu and deduce the reasons for booking late.

Patients and Methods

A cross-sectional study of two groups of women (235 participants in each group) who delivered in 4 randomly selected hospitals in Enugu. Descriptive statistics were obtained for continuous variables, and frequency and percentages were used for categorical variables. Degree of associations was determined using the Chi-square, the student's t-test, and 2 x 2 table.

Results

The prevalence of anemia among women that booked late and early were (69.7%; n = 147) and (50.7%; n = 107) respectively. Women who booked late were two times more likely to have anemia than those who booked early (OR = odds ratio, p = p-value, CI = confidence interval,). Those who booked late were six times more likely to deliver low birth weight babies than those who booked early (OR = 5.934, 95% CI = 1.299-27.119, P = 0.022).

Conclusions

Late prenatal booking is associated with a high prevalence of maternal anemia in labor, low mean maternal hemoglobin, and low birth weight compared to those of women who booked early and the reasons for booking late are multifactorial.

Prevalence and predictors of placental malaria in human immunodeficiency virus-positive women in Nigeria

BACKGROUND

Human immunodeficiency virus (HIV)-infected pregnant women have alterations in cellular and humoral immunity that increase the risks to placental malaria infection.

AIM

This study aimed at determining the prevalence and predictors of placental malaria among HIV-positive women in Nigeria.

MATERIALS AND METHODS

It was a longitudinal cohort study of pregnant women receiving antenatal care at a tertiary hospital in Nigeria. Peripheral blood sample for packed cell volume estimation and placental blood sample for malaria parasite estimation were collected from each participant at a presentation in labor and upon delivery, respectively.

RESULTS

The Prevalence of placenta malaria (68.6%) and anemia (66.7%) in HIV-positive women were significantly higher than the prevalence of placental malaria (35.3%) and anemia (44.1%) in HIV-negative control (P < 0.001 and P = 0.001 respectively). The employment status was the only sociodemographic factor significantly associated with the development of placental malaria in HIV-positive women (odds ratio: 21.60; 95% confidence interval: 7.1-66.2; P< 0.001).

CONCLUSION

The prevalence of placental malaria is very high among HIV-positive women in Nigeria. Scaling up free distribution of insecticide treated nets in the short term and employment opportunities of HIV-positive women, in the long run, may reduce the prevalence of placental malaria in our population.

Prevalence and predictors of episiotomy among women at first birth in enugu, South-East Nigeria

BACKGROUND

Women having their first birth have a higher risk of episiotomies. Therefore, the study of the procedure in this group of at risk women will assist in solving some of its associated controversies.

AIM

The aim was to determine the prevalence, predictors, and outcomes of episiotomy among primigravid women in Enugu, Nigeria.

MATERIALS AND METHODS

The study was a retrospective cross-sectional review of labor ward records of women that had their first delivery at the University of Nigeria Teaching Hospital (UNTH) Enugu, over a 5-year of April 204 to March 2009. Only women that had a vaginal delivery were included in the study. Mann-Whitney U-test (continuous data) and Chi-square test (categorical data) were used for data analysis.

RESULTS

Prevalence of episiotomy in the study was 62.1% (411/662). The episiotomy rate for booked women (65.6%, 376/573) was significantly higher than that of unbooked women (39.3%, 35/89), (prevalence ratio = 1.67 [95% confidence interval: 1.28, 2.17]). The birth weights of babies delivered in the episiotomy group (median = 3.2 kg [interquartile range (IQR): 2.9-3.5]) was statistically higher than those of women who did not receive episiotomy (median, 3.1 kg [IQR: 2.7-3.4]), (Z = -3.415, P = 0.001). Proportion of newborns with low 1(st) min Apgar scores in the episiotomy group (21.7%, 89/411) was significantly lower than the no episiotomy group (15.1%, 38/251) (P = 0.04).

CONCLUSION

Prevalence of episiotomy among women that had their first births in the UNTH, Enugu was high, and the predictors included booked status of women, higher gestational age at delivery, and larger neonatal birth weight. More efforts should be made to reduce episiotomy rate in the hospital.