Objective: Effective confirmation of pregnancy is a basic component of reproductive health services. It is a determinant for accessing antenatal care (ANC) if the pregnancy is wanted and abortion services if the pregn...Objective: Effective confirmation of pregnancy is a basic component of reproductive health services. It is a determinant for accessing antenatal care (ANC) if the pregnancy is wanted and abortion services if the pregnancy is unwanted. This study examined the effect of urine pregnancy testing in the timing of presentation for pregnancy care. Method: A cross-sectional study was conducted among 320 women presenting for antenatal care and 300 women presenting for abortion at private sector clinics in Western Nigeria. Results: The median age at first presentation was 20 weeks for ANC clients and 8 weeks for abortion clients. Obtaining urine pregnancy test of one’s accord was associated with a decrease in the gestational age at presentation of 3.7 weeks and 1.5 weeks for antenatal and abortion clients, respectively, independent of all other factors. Conclusion: Bearing in mind that the clinical benefit and public health impact of early presentation for antenatal and abortion services are unequivocal, strategies aimed at decreasing gestational age at presentation for pregnancy care should be given priority. “Fast-track” urine pregnancy testing services should be promoted in the private and public clinics in Nigeria.展开更多
Background: Oxidative stress could play a part in pre-eclampsia, and there is some evidence to suggest that vitamin C and vitamin E supplements could reduce the risk of the disorder. Our aim was to investigate the pot...Background: Oxidative stress could play a part in pre-eclampsia, and there is some evidence to suggest that vitamin C and vitamin E supplements could reduce the risk of the disorder. Our aim was to investigate the potential benefit of these antioxidants in a cohort of women with a range of clinical risk factors. Methods: We did a randomised, placebo-controlled trial to which we enrolled 2410 women identified as at increased risk of pre-eclampsia from 25 hospitals. We assigned the women 1000 mg vitamin C and 400 IU vitamin E (RRR α tocopherol;n = 1199) or matched placebo (n = 1205) daily from the second trimester of pregnancy until delivery. Our primary endpoint was pre-eclampsia, and our main secondary endpoints were low birthweight ( < 2.5 kg) and small size for gestational age ( < 5th customised birthweight centile). Analyses were by intention to treat. This studyis registered as an International Standard Randomised Controlled Trial, number ISRCTN 62368611. Findings:Of 2404 patients treated, we analysed 2395 (99.6% ). The incidence of pre-eclampsia was similar in treatment and placebo groups (15% [n = 181]vs 16% [n = 187], RR 0.97[95% CI 0.80- 1.17]). More low birthweight babies were born to women who took antioxidants than to controls(28% [n = 387]vs 24% [n = 335], 1.15 [1.02- 1.30]), but small size for gestational age did not differ between groups(21% [n = 294]vs 19% [n = 259], 1.12 [0.96- 1.31]). Interpretation:Concomitant supplementation with vitamin C and vitamin E does not prevent pre-eclampsia in women at risk, but does increase the rate of babies born with a low birthweight. As such, use of these high-dose antioxidantsis not justified in pregnancy.展开更多
文摘Objective: Effective confirmation of pregnancy is a basic component of reproductive health services. It is a determinant for accessing antenatal care (ANC) if the pregnancy is wanted and abortion services if the pregnancy is unwanted. This study examined the effect of urine pregnancy testing in the timing of presentation for pregnancy care. Method: A cross-sectional study was conducted among 320 women presenting for antenatal care and 300 women presenting for abortion at private sector clinics in Western Nigeria. Results: The median age at first presentation was 20 weeks for ANC clients and 8 weeks for abortion clients. Obtaining urine pregnancy test of one’s accord was associated with a decrease in the gestational age at presentation of 3.7 weeks and 1.5 weeks for antenatal and abortion clients, respectively, independent of all other factors. Conclusion: Bearing in mind that the clinical benefit and public health impact of early presentation for antenatal and abortion services are unequivocal, strategies aimed at decreasing gestational age at presentation for pregnancy care should be given priority. “Fast-track” urine pregnancy testing services should be promoted in the private and public clinics in Nigeria.
文摘Background: Oxidative stress could play a part in pre-eclampsia, and there is some evidence to suggest that vitamin C and vitamin E supplements could reduce the risk of the disorder. Our aim was to investigate the potential benefit of these antioxidants in a cohort of women with a range of clinical risk factors. Methods: We did a randomised, placebo-controlled trial to which we enrolled 2410 women identified as at increased risk of pre-eclampsia from 25 hospitals. We assigned the women 1000 mg vitamin C and 400 IU vitamin E (RRR α tocopherol;n = 1199) or matched placebo (n = 1205) daily from the second trimester of pregnancy until delivery. Our primary endpoint was pre-eclampsia, and our main secondary endpoints were low birthweight ( < 2.5 kg) and small size for gestational age ( < 5th customised birthweight centile). Analyses were by intention to treat. This studyis registered as an International Standard Randomised Controlled Trial, number ISRCTN 62368611. Findings:Of 2404 patients treated, we analysed 2395 (99.6% ). The incidence of pre-eclampsia was similar in treatment and placebo groups (15% [n = 181]vs 16% [n = 187], RR 0.97[95% CI 0.80- 1.17]). More low birthweight babies were born to women who took antioxidants than to controls(28% [n = 387]vs 24% [n = 335], 1.15 [1.02- 1.30]), but small size for gestational age did not differ between groups(21% [n = 294]vs 19% [n = 259], 1.12 [0.96- 1.31]). Interpretation:Concomitant supplementation with vitamin C and vitamin E does not prevent pre-eclampsia in women at risk, but does increase the rate of babies born with a low birthweight. As such, use of these high-dose antioxidantsis not justified in pregnancy.
