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Onubogu CU, Ekwochi U, Obumneme-Anyim I, Nwokeji-Onwe LN, Eleje GU, Ojiegbe NO, Ezebialu IU, Ezenkwele EP, Nzeribe EA, Umeh UA, Ugwu IA, Chianakwana O, Ibekwe NT, Ezeaku OI, Ekweagu GN, Onwe AB, Lavin T, Ezekwe B, Settecase E, Tukur J, Ikechebelu JI. Prevalence, perinatal outcomes and factors associated with neonatal sepsis in Nigeria. BJOG 2024. [PMID: 38602158 DOI: 10.1111/1471-0528.17824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/19/2024] [Accepted: 03/24/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE To examine the prevalence, perinatal outcomes and factors associated with neonatal sepsis in referral-level facilities across Nigeria. DESIGN Secondary analysis of data from the Maternal and Perinatal Database for Quality, Equity and Dignity Programme in 54 referral-level hospitals across Nigeria. SETTING Records covering the period from 1 September 2019 to 31 August 2020. POPULATION Mothers admitted for birth during the study period, and their live newborns. METHODS Analysis of prevalence and sociodemographic and clinical factors associated with neonatal sepsis and perinatal outcomes. Multilevel logistic regression modelling identified factors associated with neonatal sepsis. MAIN OUTCOME MEASURES Neonatal sepsis and perinatal outcomes. RESULTS The prevalence of neonatal sepsis was 16.3 (95% CI 15.3-17.2) per 1000 live births (1113/68 459) with a 10.3% (115/1113) case fatality rate. Limited education, unemployment or employment in sales/trading/manual jobs, nulliparity/grand multiparity, chronic medical disorder, lack of antenatal care (ANC) or ANC outside the birthing hospital and referral for birth increased the odds of neonatal sepsis. Birthweight of <2500 g, non-spontaneous vaginal birth, preterm birth, prolonged rupture of membranes, APGAR score of <7 at 5 min, birth asphyxia, birth trauma or jaundice were associated with neonatal sepsis. Neonates with sepsis were more frequently admitted to a neonatal intensive care unit (1037/1110, 93.4% vs 8237/67 346, 12.2%) and experienced a higher rate of death (115/1113, 10.3% vs 933/67 343, 1.4%). CONCLUSIONS Neonatal sepsis remains a critical challenge in neonatal care, underscored by its high prevalence and mortality rate. The identification of maternal and neonatal risk factors underscores the importance of improved access to education and employment for women and targeted interventions in antenatal and intrapartum care.
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Affiliation(s)
- Chinyere Ukamaka Onubogu
- Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Paediatrics, Nnamdi Azikiwe University, Faculty of Medicine, Nnewi Campus, Anambra State, Nigeria
| | - Uchenna Ekwochi
- Department of Paediatrics, Enugu State University Teaching Hospital, Parklane, Enugu State, Nigeria
| | - Ijeoma Obumneme-Anyim
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Linda Nneka Nwokeji-Onwe
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - George Uchenna Eleje
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Faculty of Medicine, Nnewi Campus, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | | | - Ifeanyichukwu Uzoma Ezebialu
- Department of Obstetrics and Gynaecology, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
| | - Eziamaka Pauline Ezenkwele
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | | | - Uchenna Anthony Umeh
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Innocent Anayochukwu Ugwu
- Department of Obstetrics & Gynaecology, Enugu State University Teaching Hospital, Parklane, Enugu State, Nigeria
| | - Ogochukwu Chianakwana
- Department of Medical Records, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Nkechi Theresa Ibekwe
- Department of Medical Records, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Onyebuchi Ignatius Ezeaku
- Department of Medical Records, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Gloria Nwuka Ekweagu
- Department of Medical Records, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Abraham Bong Onwe
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Tina Lavin
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Bose Ezekwe
- Department of Ageing and Life Course, World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Eugenia Settecase
- Department of Mother & Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Jamilu Tukur
- Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Joseph Ifeanyichukwu Ikechebelu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Faculty of Medicine, Nnewi Campus, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
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Ikechebelu JI, Eleje GU, Onubogu CU, Ojiegbe NO, Ekwochi U, Ezebialu IU, Ezenkwele EP, Nzeribe EA, Umeh UA, Obumneme-Anyim I, Nwokeji-Onwe LN, Settecase E, Ugwu IA, Chianakwana O, Ibekwe NT, Ezeaku OI, Ekweagu GN, Onwe AB, Lavin T, Tukur J. Incidence, predictors and immediate neonatal outcomes of birth asphyxia in Nigeria. BJOG 2024. [PMID: 38560768 DOI: 10.1111/1471-0528.17816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/01/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To determine the incidence and sociodemographic and clinical risk factors associated with birth asphyxia and the immediate neonatal outcomes of birth asphyxia in Nigeria. DESIGN Secondary analysis of data from the Maternal and Perinatal Database for Quality, Equity and Dignity Programme. SETTING Fifty-four consenting referral-level hospitals (48 public and six private) across the six geopolitical zones of Nigeria. POPULATION Women (and their babies) who were admitted for delivery in the facilities between 1 September 2019 and 31 August 2020. METHODS Data were extracted and analysed on prevalence and sociodemographic and clinical factors associated with birth asphyxia and the immediate perinatal outcomes. Multilevel logistic regression modelling was used to ascertain the factors associated with birth asphyxia. MAIN OUTCOME MEASURES Incidence, case fatality rate and factors associated with birth asphyxia. RESULTS Of the available data, 65 383 (91.1%) women and 67 602 (90.9%) babies had complete data and were included in the analysis. The incidence of birth asphyxia was 3.0% (2027/67 602) and the case fatality rate was 16.8% (339/2022). The risk factors for birth asphyxia were uterine rupture, pre-eclampsia/eclampsia, abruptio placentae/placenta praevia, birth trauma, fetal distress and congenital anomaly. The following factors were independently associated with a risk of birth asphyxia: maternal age, woman's education level, husband's occupation, parity, antenatal care, referral status, cadre of health professional present at the birth, sex of the newborn, birthweight and mode of birth. Common adverse neonatal outcomes included: admission to a special care baby unit (SCBU), 88.4%; early neonatal death, 14.2%; neonatal sepsis, 4.5%; and respiratory distress, 4.4%. CONCLUSIONS The incidence of reported birth asphyxia in the participating facilities was low, with around one in six or seven babies with birth asphyxia dying. Factors associated with birth asphyxia included sociodemographic and clinical considerations, underscoring a need for a comprehensive approach focused on the empowerment of women and ensuring access to quality antenatal, intrapartum and postnatal care.
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Affiliation(s)
- Joseph Ifeanyichukwu Ikechebelu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - George Uchenna Eleje
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | | | | | - Uchenna Ekwochi
- Department of Paediatrics, ESUT Teaching Hospital, Enugu, Nigeria
| | - Ifeanyichukwu Uzoma Ezebialu
- Department of Obstetrics and Gynaecology, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
| | - Eziamaka Pauline Ezenkwele
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | | | - Uchenna Anthony Umeh
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Ijeoma Obumneme-Anyim
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Linda Nneka Nwokeji-Onwe
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Eugenia Settecase
- Department of Mother & Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | | | - Ogochukwu Chianakwana
- Department of Medical Records, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Nkechi Theresa Ibekwe
- Department of Medical Records, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Onyebuchi Ignatius Ezeaku
- Department of Medical Records, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Gloria Nwuka Ekweagu
- Department of Medical Records, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Abraham Bong Onwe
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Tina Lavin
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Jamilu Tukur
- Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria
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Oguejiofor CB, Ebubechukwu KM, Eleje GU, Ugwu EO, Enebe JT, Ekwuazi KE, Okoro CC, Okpala BC, Okafor CC, Ezeora NC, Iloghalu EI, Anikwe CC, Okafor CG, Agu PU, Igbodike EP, Ake ID, Onwuegbuna AA, Umeononihu OS, Anaedu OP, Ikpeze OZ, Ikwuka DC, Nwaolisa HI, Emeka EA, Okoye JO, Osuagwu IK, Ugwu AO, Ejikeme TB, Ezenkwele EP, Ezeigwe CO, Nwankwo ME, Udigwe GO, Ikechebelu JI, Agbaeze G, Nwanja CD, Eke AC. The impact of COVID-19 on the birth rate in Nigeria: a report from population-based registries. Infect Dis Res 2023; 4:4. [PMID: 37986732 PMCID: PMC10659584 DOI: 10.53388/idr2023004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background and objectives Coronavirus disease 2019 (COVID-19) is a pandemic that has become a major source of morbidity and mortality worldwide, affecting the physical and mental health of individuals influencing reproduction. Despite the threat, it poses to maternal health in sub-Saharan Africa and Nigeria, there is little or no data on the impact it has on fertility, conception, gestation and birth. To compare the birth rate between pre-COVID and COVID times using selected months of the year. Materials and methods This was a secondary analysis of cross-sectional analytical study data from the birth registries of three tertiary hospitals, comparing two years [2019 (Pre-COVID)] versus [2020 (COVID era)] using three months of the year (October to December). The data relied upon was obtained from birth registries in three busy maternity clinics all within tertiary hospitals in South-East Nigeria and we aimed at discussing the potential impacts of COVID-19 on fertility in Nigeria. The secondary outcome measures were; mode of delivery, booking status of the participants, maternal age and occupation. Results There was a significant decrease in tertiary-hospital based birth rate by 92 births (P = 0.0009; 95% CI: -16.0519 to -4.1481) among mothers in all the three hospitals in 2020 during the COVID period (post lockdown months) of October to December. There was a significant difference in the mode of delivery for mothers (P = 0.0096) with a 95% confidence interval of 1.0664 to 1.5916, as more gave birth through vaginal delivery during the 2020 COVID-19 period than pre-COVID-19. Conclusion Tertiary-hospital based birth rates were reduced during the pandemic. Our multi-centre study extrapolated on possible factors that may have played a role in this decline in their birth rate, which includes but is not limited to; decreased access to hospital care due to the total lockdowns/curfews and worsening inflation and economic recession in the country.
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Affiliation(s)
| | - Kenechi Miracle Ebubechukwu
- Preventive Medicine and Research Department, Clina-Lancet Laboratories, Victoria Island, Lagos 101241, Nigeria
| | - George Uchenna Eleje
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi Campus 435001, Nigeria
| | - Emmanuel Onyebuchi Ugwu
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Enugu State 400102, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State 400102, Nigeria
| | - Joseph Tochukwu Enebe
- Department of Obstetrics and Gynecology, ESUT Teaching Hospital, Parklane, Enugu 400102, Nigeria
| | - Kingsley Emeka Ekwuazi
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Enugu State 400102, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State 400102, Nigeria
| | | | - Boniface Chukwuneme Okpala
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi Campus 435001, Nigeria
| | | | - Nnanyelugo Chima Ezeora
- Department of Obstetrics and Gynecology, ESUT Teaching Hospital, Parklane, Enugu 400102, Nigeria
| | - Emeka Ifeanyi Iloghalu
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Enugu State 400102, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State 400102, Nigeria
| | - Chidebe Christian Anikwe
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
| | - Chigozie Geoffrey Okafor
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
| | - Polycarp Uchenna Agu
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Enugu State 400102, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State 400102, Nigeria
| | - Emeka Philip Igbodike
- Department of Obstetrics and Gynecology, Havana Specialist Hospital, Surulere, Lagos 100011, Nigeria
| | - Iffiyeosuo Dennis Ake
- Clinical Trial Division, Drug Evaluation and Research Directorate, NAFDAC office Complex, Lagos 100011, Nigeria
| | | | - Osita Samuel Umeononihu
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
| | - Onyedika Promise Anaedu
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
| | - Odigonma Zinobia Ikpeze
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
| | - David Chibuike Ikwuka
- Department of Human Physiology, Nnamdi Azikiwe University Nnewi, Anambra State 435001, Nigeria
| | - Henry Ifeanyi Nwaolisa
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
| | - Ekene Agatha Emeka
- Department of Family Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka 435001, Nigeria
| | - Jude Ogechukwu Okoye
- Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka 435001, Nigeria
| | | | - Angela Ogechukwu Ugwu
- Department of Haematology and Immunology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Enugu State 400102, Nigeria
| | - Toochukwu Benjamin Ejikeme
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
| | - Eziamaka Pauline Ezenkwele
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Enugu State 400102, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State 400102, Nigeria
| | | | - Malarchy Ekwunife Nwankwo
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
| | - Gerald Okanandu Udigwe
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
- Preventive Medicine and Research Department, Clina-Lancet Laboratories, Victoria Island, Lagos 101241, Nigeria
| | - Joseph Ifeanyichukwu Ikechebelu
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi PMB 5025, Nigeria
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi Campus 435001, Nigeria
| | - Grace Agbaeze
- Musgrove Park Hospital Somerset NHS, Foundation Trust, United Kingdom
| | | | - Ahizechukwu Chigoziem Eke
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore 21201, U.S.A
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Eleje GU, Ugwu EO, Enebe JT, Okoro CC, Okpala BC, Ezeora NC, Iloghalu EI, Anikwe CC, Okafor CG, Agu PU, Igbodike EP, Ake ID, Ekwuazi KE, Onwuegbuna AA, Umeononihu OS, Anaedu OP, Ikwuka DC, Nwaolisa HI, Njoku CC, Nwankwo CP, Emeka EA, Eleje LI, Adinnu KM, Okoye CO, Ugwu AO, Nwachukwu EO, Mba SG, Ezenkwele EP, Okoye UE, Ofiaeli CI, Ikpeze GC, Onah LN, Ikpeze OZ, Ejikeme TB, Udigwe GO, Ikechebelu JI. Cesarean section rate and outcomes during and before the first wave of COVID-19 pandemic. SAGE Open Med 2022; 10:20503121221085453. [PMID: 35342633 PMCID: PMC8949745 DOI: 10.1177/20503121221085453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 02/16/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: The objective of the study was to assess how the current COVID-19 pandemic has affected cesarean section (C-section) rates, indications, and peripartum outcomes. Methods: This was a retrospective cross-sectional study that compared a 3-month rates of and indications for C-sections at three tertiary health care institutions in Nigeria before (October 2019–December 2019) and during the first wave of COVID-19 pandemic (March 2020–May 2020). Primary outcomes were C-section rate and indications between the two periods. Data were analyzed using SPSS 26.0 IBM Corporation. Rates and odds ratios with 95% confidence intervals were used to quantify indications and peripartum outcomes and statistical significance was accepted when p value was <0.05. Results: The baseline characteristics of the two groups were similar. The C-section rate during the COVID-19 period was significantly less than the period prior to the pandemic (237/580, 40.0% vs 390/833, 46.8%; p = 0.027). The rates of postdatism (odds ratio = 1.47, 95% confidence interval = 1.05–2.05, p = 0.022), fetal distress (odds ratio = 3.06, 95% confidence interval = 1.55–6.06, p = 0.017), emergency C-section (odds ratio = 1.43, 95% confidence interval = 1.01–2.05, p = 0.042), and anemia (odds ratio = 1.84, 95% confidence interval = 1.12–3.03, p = 0.016) were significantly higher during the pandemic than prepandemic. Conclusion: The overall C-section rate during the first wave of COVID-19 was significantly lower than the prepandemic period. There were higher rates of postdatism, fetal distress, emergency C-section, and postpartum anemia. Further studies on this changing C-section trend during the pandemic are needed.
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Affiliation(s)
- George Uchenna Eleje
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- George Uchenna Eleje, Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi Campus, P.M.B. 5025, Nnewi, Anambra State 435001, Nigeria.
| | - Emmanuel Onyebuchi Ugwu
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku, Nigeria
| | | | | | - Boniface Chukwuneme Okpala
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | | | - Emeka Ifeanyi Iloghalu
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku, Nigeria
| | - Chidebe Christian Anikwe
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Chigozie Geoffrey Okafor
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Polycarp Uchenna Agu
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku, Nigeria
| | - Emeka Philip Igbodike
- Department of Obstetrics and Gynecology, Georges Hospital Memorial Medical Centre, Lagos, Nigeria
| | - Iffiyeosuo Dennis Ake
- Clinical Trial Division, Drug Evaluation and Research Directorate, NAFDAC, Lagos, Nigeria
| | - Kingsley Emeka Ekwuazi
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku, Nigeria
| | | | - Osita Samuel Umeononihu
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Onyedika Promise Anaedu
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | | | - Henry Ifeanyi Nwaolisa
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Chukwuemeka Chidindu Njoku
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Chidinma Patricia Nwankwo
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Ekene Agatha Emeka
- Department of Family Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
| | - Lydia Ijeoma Eleje
- Measurement, Evaluation and Research Unit, Department of Educational Foundations, Nnamdi Azikiwe University, Awka, Nigeria
| | | | | | - Angela Ogechukwu Ugwu
- Department of Haematology and Immunology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | | | - Sunday Gabriel Mba
- Department of Obstetrics and Gynecology, ESUT Teaching Hospital, Enugu, Nigeria
| | - Eziamaka Pauline Ezenkwele
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku, Nigeria
| | | | - Chika Ifeoma Ofiaeli
- Department of Family Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
| | - Golibe Christian Ikpeze
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | | | - Odigonma Zinobia Ikpeze
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | | | - Gerald Okanandu Udigwe
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Joseph Ifeanyichukwu Ikechebelu
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
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Eleje GU, Ezugwu EC, Ogunyemi D, Eleje LI, Ikechebelu JI, Igwegbe AO, Okonkwo JE, Ikpeze OC, Udigwe GO, Onah HE, Nwosu BO, Ezeama CO, Ezenkwele EP. Accuracy and cost-analysis of placental alpha-microglobulin-1 test in the diagnosis of premature rupture of fetal membranes in resource-limited community settings. J Obstet Gynaecol Res 2014; 41:29-38. [DOI: 10.1111/jog.12475] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 04/16/2014] [Indexed: 11/30/2022]
Affiliation(s)
- George Uchenna Eleje
- Department of Obstetrics and Gynecology; Nnamdi Azikiwe University Teaching Hospital; Nnewi Nigeria
| | - Euzebus Chinonye Ezugwu
- Department of Obstetrics and Gynaecology; University of Nigeria Teaching Hospital; Enugu Nigeria
| | - Dotun Ogunyemi
- Department of Obstetrics and Gynecology; David Geffen School of Medicine at UCLA; Los Angeles California USA
| | - Lydia Ijeoma Eleje
- Measurement and Evaluation Unit; Department of Education Foundation; Nnamdi Azikiwe University; Awka Nigeria
| | | | - Anthony Osita Igwegbe
- Department of Obstetrics and Gynecology; Nnamdi Azikiwe University Teaching Hospital; Nnewi Nigeria
| | - John E. Okonkwo
- Department of Obstetrics and Gynecology; Nnamdi Azikiwe University Teaching Hospital; Nnewi Nigeria
| | | | - Gerald Okanandu Udigwe
- Department of Obstetrics and Gynecology; Nnamdi Azikiwe University Teaching Hospital; Nnewi Nigeria
| | - Hyacinth Eze Onah
- Department of Obstetrics and Gynaecology; University of Nigeria Teaching Hospital; Enugu Nigeria
| | - Betrand Obi Nwosu
- Department of Obstetrics and Gynecology; Nnamdi Azikiwe University Teaching Hospital; Nnewi Nigeria
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Abstract
The study was done to determine obstetricians' attitude to and factors predicting obstetricians' acceptance of caesarean delivery on maternal request in Nigeria. Nigerian obstetricians were asked to respond to case scenarios depicting caesarean delivery on maternal request without medical indications and the reasons for their responses. The case scenarios were designed from previously published reasons for caesarean delivery on maternal request from Nigeria. Multiple logistic regressions analysis was done to determine factors predicting obstetricians' acceptance of caesarean delivery on maternal request out of respect for maternal autonomy. The majority (53.1%) of the respondents would accept caesarean delivery on maternal request out of respect for maternal autonomy. Caesarean requests backed up by social mitigating circumstances of previous childlessness and previous negative labour experience received significantly higher acceptances than requests with no back-up mitigating circumstances (p < 0.0001). A good proportion (48.8%) of Nigerian obstetricians had performed at least one caesarean on maternal request. Obstetricians' bio-professional characteristics do not influence their attitude to request caesarean delivery on maternal request. Some obstetricians expressed fear of legal consequences from caesarean delivery on maternal request.
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Affiliation(s)
- C O Chigbu
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
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