Knowledge of breastfeeding-related musculoskeletal disorders and suitable breastfeeding positions among pregnant women in Enugu, Nigeria

Background: Early booking in the first trimester is recommended, and it is known to be of great benefit for the mother and the fetus. Aim: The aim of this study was to determine the profile and predictors of early prenatal booking among pregnant women in Enugu, Nigeria. Materials and Methods: A cross-sectional study was conducted on 200 consecutive pregnant women attending booking clinic at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Statistical analysis was both descriptive and inferential at 95% confidence level, and carried out using the Statistical Package for the Social Sciences (SPSS) software, version 22.0, IBM SPSS, Chicago, Illinois. A P value of less than 0.05 was considered statistically significant. Results: The mean gestational age at booking was 18.6 ± 8.4 weeks. Although 37% (n = 74) of the women booked early in the first trimester; only 36% of the respondents (n = 72) were aware of the right time to book for prenatal care. More than half (56.8%, 42 of 74) of the women, who booked early for prenatal care, had problems in their last pregnancies, whereas 43.2% (n = 32 of 74) of them had problems in their index pregnancies. Parity, secondary level of education, and problems in the previous and index pregnancies were significantly associated with early booking after adjusting for other variables in the multiple logistic regression analysis (P < 0.05). Conclusion: Pregnant women in Enugu still book late for prenatal care. There is a need to create more awareness in this regard among women of reproductive age. Factors contributing to early booking in Enugu, include parity, secondary level of education as well as problems in the previous and index pregnancies.

BackgroundHepatitis B immunoprophylaxis reduces the rate of mother-to-child transmission of hepatitis B virus infection and has effectively reduced the global burden of the hepatitis B virus infection. However, the cost of hepatitis B immunoglobulin could be prohibitive hampering adequate utilization in pregnancy and childbirth. Cost may affect pregnant women’s willingness to pay (WTP) for the immunoglobulin. The WTP for hepatitis B immunoglobulin has not been critically studied in Enugu, Nigeria. The objective of the study was to determine the willingness of pregnant women to pay for hepatitis B immunoglobulin and to identify the predictors of the level of WTP among pregnant women in Enugu, Nigeria.MethodsA cross-sectional study that involved 379 pregnant women who were selected through a multi-stage sampling technique from the health facilities in Enugu between March and November 2019 was conducted. A structured pre-tested interviewer-administered questionnaire was used for data collection. The contingent valuation technique was utilized for eliciting values attached to hepatitis B immunoglobulin by the pregnant women while the bidding game technique was used to determine the maximum amounts the participants were willing to pay. Data were analyzed using SPSS version 23. A p-value of 0.05 was regarded as significant.ResultsMost respondents (86.2%) were willing to pay for the hepatitis B immunoglobulin. The mean maximum amount of WTP was ₦23178.34 (62.64 USD). The price of hepatitis B immunoglobulin (48.8%) was a major hindrance to WTP and 36.9% of the respondents believed that the government should pay for the vaccines. Predictors of the average WTP amount were the level of education (p = 0.038, AOR = 2.645 CI: 1.055–6.630), participants’ husbands’ occupation, and weekly expenditure on food items (P = 0.041; AOR = 3.828, CI: 1.055–13.893).ConclusionsThe rate of WTP for hepatitis B immunoglobulin was 86.2%, however, the mean WTP amount was far below the market value of hepatitis B immunoglobulin. The major hindrance to WTP was the cost of the vaccine as most participants believed that the vaccine should be administered freely and financed by the government and its agencies. The predictors of willingness to pay were the participant’s level of education, husband’s occupation and weekly expenditure on food.Trial registrationNot applicable.

Introductiondomestic abuse against women is very common globally and has far-reaching consequences on the society. Therefore, it is essential to deeply study the seriousness of this public health issue among our pregnant women. The objectives were to determine the prevalence, pattern, and predictors of domestic abuse among pregnant women in Enugu, Nigeria.Methodsa cross-sectional study of 400 consenting pregnant women at the antenatal clinics of the University of Nigeria Teaching Hospital Ituku-Ozalla, Nigeria. Each woman completed a modified abuse assessment screen structured questionnaire. Data analysis was descriptive and inferential with Chi-square and multivariate binary logistic regression using SPSS version 21. A p-value of <0.05 was considered statistically significant.Resultsa total of 172 out of 400 respondents (43.0%) had ever experienced domestic abuse in their pregnancies. One hundred and ten (37.2%; 110/296) of the multigravid women were abused in previous pregnancies while 137 (34.3%; 137/400) of all respondents were being abused in the current pregnancy. For all pregnancies, the most common type of abuse experienced by the respondents was verbal abuse (85.5%; 147/172), while the commonest perpetrators of abuse were the respondents´ spouses for both the index pregnancy (82.5%; 113/137) and previous pregnancies (84.5%; 93/110). The most common women perceived cause of abuse was financial constraints (68.6%; 118/172). Age less than 25 years (AOR=1.9, 95% CI=1.01-3.76, p=0.048), not having tertiary education (AOR=2.0, 95% CI=1.17 - 3.25, p=0.01), having at least a male child (AOR=3.3, 95% CI=1.71 - 6.40, p=<0.001), and maternal unemployed status (AOR=2.0, 95% CI=1.27 - 3.19, p=0.003) were the identified predictors among women abused in pregnancy.Conclusionthe prevalence of domestic abuse was high among pregnant women in the University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria. The predominant women perceived cause of domestic abuse was financial constraints while age less than 25 years, not having tertiary education, having at least a male child, and maternal unemployed status were the predictors in abused women. Domestic abuse poses a great threat to women´s reproductive health, and so, its screening should be incorporated into antenatal care in our environment.

This present 4 – year comparative study investigated the distribution pattern of Haemoglobin genotypes and anaemic status of HIV positive pregnant women in Enugu. Haemoglobin variants(HbAA, HbAS, HbSS) in pregnant women attending antenatal clinics at the study site were determined by electrophoreisis. HIV screening tests were done using the Quick test kits. Packed Cell Volume (PCV) was estimated by using standard procedures. Results showed a prevalence rate of 83.3% was obtained for HbAA HIV+ pregnant women as against a 70.1% for HIV- pregnant women; HbAS rates were 16.7% for HIV+ pregnant women and 29.9% for HIV- pregnant women. For the non- pregnant women (control), the rates were 78.63% for HbAA and 21.4% for HbAS. No HbSS genotype was observed in the HIV+ pregnant women and HIV- pregnant women and the control respectively. The HIV seroprevalence rate of 3.67 +- 0.40%(SEM) was obtained for this study. The PCVs of the HIV+ pregnant women with HbAA and HbAS (1999 – 2002) fell into levels indicative of anaemia when compared with those of HIV- pregnant women and the control. Increased awareness, compulsory pre-marital sickling and HIV tests could be the possible reason for the low HIV seroprevalence and the absence of HbSS observed in this population. Nigerian Journal of Health and Biomedical Sciences Vol. 7 (1) 2008 pp. 27-30

Aim: To determine the knowledge, beliefs and practices towards malaria amongst pregnant women in Enugu. Method: A cross sectional survey of 300 consecutive pregnant women attending the antenatal clinics of University of Nigeria Teaching Hospital Enugu was carried out. The survey instrument was a questionnaire with questions covering various aspects of malaria including causes, prevention and treatment practices. Results: One hundred and thirty two (53.1%) of the pregnant women had correct knowledge of the aetiology of malaria while 103 (41.3%) still attributed the aetiology of malaria to other factors including excessive ingestion of oil, overexposure to sunlight, bite of cockroach, witches and poisoned food. Knowledge of the causes of malaria was directly proportional to the educational attainment of the women. Most respondents showed correct knowledge concerning symptoms of malaria and fever was the most acknowledged symptom; 234 (94.0%) believed malaria could be prevented and knowledge and practice of malaria preventive measures were also high. The major determinants of choice of preventive measures adopted by the women were perceived reliability 178 (71.2%) and ease of administration 76 (30.4). Treatment choices of malaria amongst the women were oral drugs 123 (49.4%), injections 116 (46.6%) herbs 5 (2.0%) and unspecified 5(2.0%). In the event of an attack of malaria 160 (64.3%) of the pregnant women would visit a doctor, 44.7 (17.7%) would engage in home treatment with drugs mainly analgesics and antimalarials, while the rest would resort to either treatment with herbs, visit to chemists or resorted to prayers. Conclusion: The study has demonstrated a fair knowledge of causes of malaria and its preventive measures. However a few grey areas have been identified. The belief in other causes of malaria apart from mosquitoes as widely held by the women could cause a diversion of attention to preventive measures from mosquito bites. Sustained health education especially to less educated women is strongly advocated to enhance to knowledge of malaria and practice of preventive measures. Key Words: Knowledge. Belief, Practices, Malria Prevention, Pregnant Women. [Jnl College of Medicine Vol.7(2) 2002: 92-94]

Introduction:Pregnancy has been associated with changes in the eye which could be physiological, pathological, or exacerbation of pre-existing ocular conditions. Visual acuity (VA) and refractive error (RE) changes are part of the physiological changes that may occur during pregnancy.Objective:The objective of the present study was to investigate changes in VA and RE across two different trimesters and six weeks postpartum among pregnant women in Enugu, southeast, Nigeria.Materials and Methods:A longitudinal study was adopted and pregnant women in their second trimester attending antenatal clinic at University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu were consecutively recruited. A questionnaire was used to obtain information on their sociodemographic and clinical characteristics. Visual acuity was measured and refractive error monitored in second and third trimesters and 6 weeks after delivery.Results:The mean age of women was 30.81 (±5.49) years and a majority of them were civil servants. There was a worsening of VA for distance in more women in the third trimesters compared to the second trimester. There was no significant change in VA for near throughout the study period. There was an increased myopic shift in more pregnant women during the third trimester (40; 40.0%) compared to second trimester (36; 36.0%). The most common refractive error found among the women was simple myopia. These changes resolved six weeks postpartum.Conclusion:Pregnancy worsened VA for distance and the most common RE in pregnant women was simple myopia. However, these changes resolved during the postpartum period.

The goal of roll back malaria partnership is to achieve universal coverage for all populations at risk using appropriate interventions for prevention and case management. The objective of this study is to determine the use of insecticide treated nets (ITNs) and other anti-vector measures among pregnant women in an area hyper-endemic for malaria. Questionnaires were administered to a cross-section of 832 consecutive pregnant women attending antenatal care in three hospitals in Enugu, Nigeria that have high client flow for maternity services. Data collected were analyzed using descriptive and inferential statistics by means of the Statistical Package for Social Sciences (SPSS) version 16. P-value of less than 0.05 was considered statistically significant. The mean age of the women was 33.2 ± 2.9 (range: 15-45) years. Three hundred and fifty nine (43.1%) women owned insecticide treated nets (ITNs), however 325(90.5%) slept under the nets during the index pregnancies; equivalent to 39.1% utilization rate among the 832 women studied. Out of the 325 (39.1%) women that used ITNs; 236 (28.4%) used it singly, while 89 (10.7%) used it in combination with other anti-vector measures. Educational status and social class of the women had strong association with the use of ITNs (P < 0.0001). Women who used ITNs were significantly less likely to have acute malaria, anaemia and babies with low birth weight than women who did not use ITNs (P < 0.05). The use of ITNs is poor among pregnant women in Enugu, but associated with favorable maternal and feto-neonatal outcome. Future measures to increase its use should consider improvement in educational level and social class of our women.

Objective: Metabolic syndrome is a global health problem which involves a cluster of conditions that increases the risk of heart disease, stroke and diabetes. Pregnancy induces significant physiological, hormonal and metabolic changes in a woman. The complex of metabolic and hormonal disorders is a risk factor for clinical manifestations of cardiovascular diseases, nephropathy and retinopathy. This study assessed some biochemical changes and associated metabolic syndrome among pregnant women in Enugu, Nigeria. Methods: A total of one hundred and thirty apparently healthy women consisting of seventy pregnant women as test group and sixty non-pregnant women as control group were recruited for this cross sectional study. Anthropometric parameters waist circumference (WC), height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP) were measured and body mass index (BMI) calculated. Five milliliters of fasting blood samples were collected and used for the determination of fasting plasma glucose (FPG) and lipid profile (TC, TG, HDL-C, LDL-C, VLDL-C) using enzymatic colorimetric methods. Metabolic Syndrome (MetS) prevalence was estimated using the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) criteria. Data was analysed using the Statistical Package for the Social Sciences (SPSS) version 26. Results: The results showed a significant (P&lt; 0.05) increase in BMI, WC, SBP, DBP, TG, VLDL-C and a decrease in HDL-C of pregnant women compared to non-pregnant women. Using the NCEP-ATP III criteria, it was found that about twenty-eight (40%) pregnant women had metabolic syndrome and only two (3.33%) non-pregnant woman had metabolic syndrome while the IDF criteria, presented about thirty (42.9%) pregnant women and ten (16.7%) non-pregnant women with metabolic syndrome. Conclusion: This study concludes that pregnancy predisposes women to higher risk of developing metabolic syndrome.

Hemolytic disease of the newborn, secondary to rhesus D (Rh D) iso-immunization, contributes significantly to perinatal morbidity and mortality. Prevalence data in Nigeria, and Southeast Nigeria in particular, is very scanty. This study was carried out to provide our experience in this preventable clinical condition in Enugu, Southeast Nigeria. To determine the prevalence and trends of Rh D negativity among pregnant women in Enugu, Southeast Nigeria. A 5-year retrospective study of rhesus negative women was carried out at the University of Nigeria Teaching Hospital, Enugu, Nigeria, between 1 st January 2000 and 31 st December 2004. The prevalence rate of Rh D negative women in Enugu, Nigeria, is 4.5%. Out of 6306 women who booked for antenatal care, 282 (4.5%) were Rh D negative women. One hundred and eighty-two (182) (64.5%) of the Rh D negative women were of blood group O followed by blood group A 20%, blood group B 12.1%, and blood group AB 3.2%, respectively. There is a need for adequate counseling of pregnant women on the importance of Rh D negative factor during the antenatal period in order to prevent hemolytic disease of the newborn.

Dry eye disease: A longitudinal study among pregnant women in Enugu, south east, Nigeria

Introduction: Poor oral health status in pregnant women is known to be associated with poor outcomes in pregnancies. Despite this, the oral health status of pregnant women has been grossly overlooked during antenatal period. Aim: To determine the awareness and practices of oral health among pregnant women in Enugu, Southeastern Nigeria. Materials and Methods: This was a cross-sectional questionnaire based study of 413 women who attended the antenatal clinic of University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla from January 2018 to May 2018. An interviewer administered semi-structured questionnaire which was pretested before the commencement of the study was used. The information obtained was analysed using Statistical Package for the Social Sciences (SPSS) version 22.0. A p-value of &lt;0.05 was considered statistically significant. Results: A total of 350 (84.75%) of the respondents used toothbrush and toothpaste for oral cleaning, 229 (55.45%) brushed at least twice a day while 258 (62.5%) changed their brushes every three months. Only 161 (39%) of the respondents knew that pregnancy can affect oral health while 101 (24.5%) of the respondents knew that poor oral health in pregnancy could have adverse effects on the unborn child; of whom only 30 (29.70%) got the information from their Obstetricians. Conclusion: There were knowledge gaps in the oral health of pregnant women in Enugu southeastern Nigeria. It is therefore important to provide oral health education for pregnant women during antenatal period in order to improve the health of the mother and her baby.

Anthropometry in pregnancy is a comparative measure of size, proportion and composition of the body in relation to pregnancy. Anthropometric indices are useful in the assessment of nutritional status of pregnant women and predicting pregnancy outcome. To determine the effect of gravidity on anthropometric indices of pregnant women in Enugu, South East Nigeria. This was a prospective cross sectional survey of 578 pregnant women drawn from the general population of Enugu metropolis of Nigeria. These women were randomly selected from antenatal care attendees from four peripheral hospitals in Enugu. A self-administered structured pretested questionnaire was designed. The data were analyzed by descriptive and inferential statistics using SPSS version 12, and P value less than 0.05 was considered statistically significant. The mean values of the weight, body mass index (BMI), mid upper arm. Circumference (MUAC), calf circumference (CC), waist circumference and hip circumference of pregnant women in Enugu increased significantly from primigravida to those in their forth pregnancy (P 0.05). Multigravid women have higher anthropometric indices in Enugu, Nigeria. There is need for education/enlightenment about reduction in weight gain during pregnancy after delivery. Keywords : Gravidity, Anthropometric indices, pregnancy, Enugu-Nigeria.

Antenatal care utilization is influenced by several factors. Due to our peculiar socioeconomic and cultural circumstances, gestational age at booking may be affected by certain variables. The aim of this study was to determine the influence of parity and other socio demographic factors on gestational age at booking amongst pregnant women in Enugu, South Eastern Nigeria. This is a prospective multicenter survey of randomly selected 928 pregnant women attending antenatal care for the first time in three hospitals in Enugu between January 1, 2006 to December 31, 2007. The average age was 30.22 +/- 5.2 years. The average age of the primigravidae at booking was 29.16 +/- 5.6 years.The average gestational age at booking for all the pregnant women studied was 26.12 +/- 7.6 weeks. Parity significantly [P < 0.05] influenced the gestational age at booking. Parity age for primagravidae group was 24.0 +/-7.9 weeks. Parity age for multigravidae was 27.16 +/- 7.5 weeks while for grandmultiparous women it was 26.12 +/- 7.6 weeks. Occupation did not have significant influence on gestational age at booking. It is concluded that parity significantly influenced the gestational age at booking in Enugu.

Anemia in pregnancy is highly prevalent among antenatal clinic attendees in Enugu, Nigeria despite the practice of routine iron supplementation in pregnancy. The major problem with iron supplementation in pregnancy is compliance, and this may be a potential driver to the persistent high prevalence of anemia in this population. To find out the compliance rate and determinants of compliance to iron supplementation among pregnant women in Enugu, southeastern Nigeria. This was a questionnaire-based cross-sectional study of eligible pregnant women receiving antenatal care at the University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu, Nigeria between April 1, 2012 and January 31, 2013. The knowledge of iron supplementation was 76.3% ( n = 302), however, the compliance rate was 65.9% ( n = 261). Tertiary level of education and high social class were factors significantly associated with compliance to iron supplementation after adjusting for other factors in the binary logistic regression analysis ( P < 0.05). The major barriers to compliance to iron supplementation included gastrointestinal side effects of iron supplements (41.7%), non-affordability of iron supplements (28.3%), and forgetfulness (15.0%) among the antenatal mothers. The compliance rate of 65.9% for iron supplementation by pregnant mothers in Enugu can further be improved by providing the drug free of charge in the short term and improvement in education and socioeconomic class of the populace in the long run.

Background. Volume of red cells in capillary blood varies from that of venous blood. The magnitude of this variation as well as its impact on the diagnosis of anaemia in pregnancy needs to be studied. This study demonstrates the disparity between capillary and venous PCV in pregnancy. Objectives. To determine whether capillary blood PCV (cPCV) differed from venous blood PCV (vPCV) of normal pregnant women in Enugu, Nigeria, and its effect on diagnosis and prevalence of anaemia. Methods. PCV was estimated using pairs of venous and capillary blood samples from 200 consecutive pregnant women at the Antenatal Clinic of University of Nigeria Teaching Hospital, Enugu, Nigeria. Results. Participants' cPCV (median = 34.0%, IQR = 31.0–35.8) was significantly lower than their vPCV (median = 34.0%, IQR = 32.0–37.0) (Z = −6.85, P < 0.001). However, women's cPCV had strong positive correlation with their vPCV (r = 0.883, P < 0.001). The prevalence of anaemia among participants using capillary and venous blood was 33.5% (67/200) and 28.0% (56/200), respectively (O.R = 1.3 (CI 95%: 0.85, 1.98), P = 0.233). Conclusions. Capillary blood PCV was lower than vPCV among pregnant women in Enugu, Nigeria. Nevertheless, the prevalence of anaemia derived from cPCV did not differ significantly from that of vPCV.