ObjectiveThe purpose of this study was to compare maternal weight gain in pregnancy and obstetric outcomes between women with obesity in early pregnancy and those with a normal body mass index (BMI) in early pregnancy.MethodsThis was a retrospective cohort study of women with obesity in early pregnancy and those with a normal BMI who were seen at three teaching hospitals in South-East Nigeria. Statistical analysis was performed using Statistical Package for the Social Sciences version 17.0 software, with descriptive and inferential statistics at the 95% level of confidence.ResultsThe study sample consisted of 648 women (324 obese and 324 healthy-weight). The mean age of the obese women was 26.7 ± 5.1 years and that of the healthy-weight women was 26.6 ± 4.9 years. Although both excessive weight gain (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.23–0.54) and inadequate weight gain (OR 0.08, 95% CI 0.04–0.15) were less common in women with early pregnancy obesity than in healthy-weight women, a significantly higher proportion of obese women with excessive weight gain had adverse fetomaternal outcomes. Also, a significantly higher proportion of obese women had specific complications, such as premature rupture of membranes (OR 2.36, 95% CI 1.12–5.04), gestational hypertension/pre-eclampsia (OR 2.31, 95% CI 1.12–5.04), antepartum hemorrhage (OR 2.78, 95% CI 1.02–7.93), gestational diabetes (OR 4.24, 95% CI 1.62–11.74), cesarean delivery (OR 2.3, 95% CI 1.2–5.44), macrosomia (OR 4.08, 95% CI 1.06–8.41), severe birth asphyxia (OR 2.8, 95% CI 1.2–6.63), abnormal Apgar scores (OR 2.67, 95% CI 1.46–4.93), and newborn special care admissions (OR 1.18, 95% CI 1.0–3.29).ConclusionEarly pregnancy obesity was associated with a wide range of adverse fetomaternal outcomes, and could be a genuine risk factor for increased pregnancy-related morbidity and/or mortality in this population. Interventions to reduce prepregnancy obesity could therefore be useful in this low-resource African setting.

To determine the knowledge, attitude and practice of child adoption among infertile Nigerian women we undertook a questionnaire survey of 279 consecutive infertile women seen in three tertiary care centres in South Eastern Nigeria within a 9-month period. The data were analysed by means of simple percentages and descriptive and inferential statistics, using t-tests, chi-square tests and regression equations at the 95% confidence level. Two hundred and sixty-four questionnaires were analysed. Although 228 (86.4%) of the respondents were aware of child adoption, only 72 (27.3%) knew its correct meaning. Fifty-seven (21.6%) women knew how to adopt a baby while the rest did not; 183 (69.3%) respondents expressed their unwillingness to adopt a baby while the remaining 81 (30.7%) were willing. Twelve (14.8%) of these 81 respondents (or 4.5% of all respondents) had either adopted or made an effort to adopt a child at the time of the study. The major reasons given by the 183 respondents unwilling to adopt a child were: adoption not a solution to their infertility (84 respondents); adoption psychologically unacceptable (78 respondents); fear of unknown parental background (75 respondents) and abnormal behaviour in the child (75 respondents). Univariate analysis showed six factors significantly associated with a favourable attitude to child adoption: a correct knowledge of the meaning of adoption (P=0.00007), duration of infertility >5 years (P=0.0002), previous orthodox specialist treatment (P=0.0002), tubal infertility (P=0.002), no living child (P=0.02) and maternal age >35 years (P=0.03). In a multiple logistic regression involving these six factors, with attitude to adoption as the dependent variable, two factors were associated significantly with a favourable attitude to adoption: correct knowledge of the meaning of adoption (OR=1.9, P=0.04) and previous orthodox specialist treatment (OR=2.9, P=0.05). Although the majority of infertile Nigerian women have heard of child adoption, only a minority knew its real meaning, its legality and the process it entails. Approximately one-third of them were disposed favourably to adoption as a treatment option for their infertility. The Nigerian experience was compared and contrasted with the experiences of other countries. Factors associated with a favourable attitude to adoption were presented and discussed. In the presence of such factors, especially when the probability of cure of infertility is small, child adoption as a treatment option should be offered early so that willing couples can initiate the processes.

Personal beliefs significantly affect sexual relationships between Nigerian husbands and their pregnant wives, making approximately one-third of husbands engage in extra-marital relationships as a way to satisfy their unmet sexual need during pregnancy. There is a need to educate husbands and their pregnant wives on sexual matters during pregnancy.

We aimed to assess the risk factors for hepatitis B infection among pregnant women in Enugu, southeast Nigeria. This was a prospective case-control study of risk factors for hepatitis B surface antigen positivity among pregnant women seen in two tertiary health institutions in Enugu, southeast Nigeria. It was carried out over an 8-month period, January - August 2005. Of the 1,499 pregnant women attending the antenatal clinic, 4.6% (n = 69) were seropositive for hepatitis B surface antigen. A total of 35 (50.7%) HBsAg positive women and 71 negative controls were interviewed. The risk factors for HBsAg were present in 71% (n = 25) of the positive cases, while only 27% (n = 19) of the negative cases had risk factors. The significant risk factors for HBsAg positivity were higher mean parity, higher number of sexual partners since sexual debut, polygamy and previous positive history of sexually transmitted diseases (STD) (p < 0.05). The two groups did not differ with respect to presence of tattoo or scarification marks, positive history of jaundice or contact with a jaundiced patient, previous blood transfusion or contact with blood products, intravenous drug abuse or sharing personal instruments (p > 0.05). Screening pregnant women for hepatitis B infection on the basis of presence of risk factors may not effective. Universal antenatal screening for HBsAg, health education aimed at reducing risk factors and immunisation of all newborn and those at risk of hepatitis B is advocated.

Administration of evidence based intervention is possible in low resource settings and could contribute to a significant reduction in the maternal deaths.