Abstract
The study aimed to determine if selenium deficiency, serum ceruloplasmin and traditional birth practices are risk factors for peripartum cardiomyopathy (PPCM), in Kano, Nigeria. This is a case-control study carried out in three hospitals, and PPCM patients were followed up for six months. Critically low serum selenium concentration was defined as <70 µg/L. A total of 39 PPCM patients and 50 controls were consecutively recruited after satisfying the inclusion criteria. Mean serum selenium in patients (61.7 ± 14.9 µg/L) was significantly lower than in controls (118.4 ± 45.6 µg/L) (p < 0.001). The prevalence of serum selenium <70 µg/L was significantly higher among patients (76.9%) than controls (22.0%) (p < 0.001). The mean ceruloplasmin and prevalence of socio-economic indices, multiparity, pregnancy-induced hypertension, obesity and twin pregnancy were not different between the groups (p > 0.05). Logistic regression showed that rural residency significantly increased the odds for serum selenium <70 µg/L by 2.773-fold (p = 0.037). Baseline serum levels of selenium and ceruloplasmin were not associated with six-month mortality. This study has shown that selenium deficiency is a risk factor for PPCM in Kano, Nigeria, and is related to rural residency. However, serum ceruloplasmin, customary birth practices and some other characteristics were not associated with PPCM in the study area.
Highlights
Peripartum cardiomyopathy (PPCM) is one of the most common causes of heart failure (HF) among women in Kano, other parts of northern Nigeria and Africa [1,2]
A total of 54 peripartum cardiomyopathy (PPCM) patients and 77 controls were consecutively screened, but only 39 patients and 50 controls were recruited after satisfying all the inclusion criteria, including availability of serum selenium and ceruloplasmin results
The present study has shown that socio-economic indices, multiparity, pregnancy-induced hypertension, obesity and twin pregnancy were not risk factors for PPCM in the study area [2,23]
Summary
Peripartum cardiomyopathy (PPCM) is one of the most common causes of heart failure (HF) among women in Kano, other parts of northern Nigeria and Africa [1,2]. The Hausa-Fulani tribe of northern Nigeria was described decades ago to have the highest known incidence of peripartum cardiac failure (PPCF) which was linked to some peculiar local puerperal customs which were practiced for as long as 3 months from the time of delivery [5,6,7] These include twice-daily hot baths, of which the leaves of local trees were used to splash very hot water on the body for about 15–30 min, “wankan jego” (in Hausa language), lying on beds made of clay which is heated from below with firewood, in spite of the hot weather, and frequent ingestion of pap made from millet and enriched with dried lake salt, “Kunun Kanwa” (in Hausa language) [5,6,7]. Epidemiologic studies showed that low selenium levels in the soil and in local foodstuffs correlated with low selenium levels in whole-blood and hair samples, and treatment with sodium selenite prevented Keshan disease and mitigated the clinical manifestations in patients with the disease [8,9,10,11,12]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
