ASSESSMENT OF COTININE AS A BIOMARKER OF CIGARETTE SMOKING AND SELF-REPORTED SMOKING STATUS AMONG UNDERGRADUATE STUDENTS OF AHMADU BELLO UNIVERSITY, ZARIA
INTRODUCTION: Preeclampsia is associated with increased maternal and neonatal morbidities
and mortalities. These include placental abruption, eclampsia, acute renal failure, cerebrovascular accident, preterm births and its sequelae. It is therefore important to ensure an accurate method of preventing the complications from this condition.
AIM:To assess the efficacy of low dose aspirin in preventing preeclampsia and improving fetal outcome among pregnant women at risk
DESIGN: A double blind randomised controlled study.
SETTING: The study was conducted at the Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Ilorin, Kwara state, Nigeria.
STUDY POPULATION: Pregnant women at 12-20 weeks of gestation with risk of developing preeclampsia on low dose aspirin tablets while controls were pregnant women with same risk factors on placebo.
METHODS: A total of two hundred and seventy six pregnant women at 12-20 weeks of gestation were recruited for the study but data for two hundred and sixty five women was obtained and analysed. Seven of the participants did not comply with the drugs and four were lost to follow up. Group I consisted of one hundred and thirty consenting pregnant women on low dose aspirin while one hundred and thirty five of the participants served as controls on placebo (group II). They all had either low dose aspirin tablets or placebo ingested and monitored till 6 weeks post partum .Blood pressures and urinalysis/24-hour urine protein estimation done at each visit as
required and the findings was compared between the two groups to determine the efficacy of low dose aspirin in the prevention of preeclampsia and perinatal outcomes.
RESULTS: The proportion of preeclampsia in pregnancies at risk was 15.8% while proportion of preeclampsia in the low dose aspirin and placebo groups were 11.5% and 20.0% respectively. There was no statistical significant difference between low dose aspirin and placebo in the prevention of preeclampsia in pregnant women with risk factors like previous history ofpreeclampsia, chronic hypertension, pregestational and gestational diabetes mellitus, age≥40 years, nulliparity, twin gestation and body mass index≥30kg/m2(p=0.060).
There was no statistical difference in APGAR score and neonatal intensive care admission (NICU) in neonate of participants in both groups. However, participants on placebo delivered earlier than those on low dose aspirin with a statistical significance (p<0.001).There was also greater birth weights among neonates of participants on LDA (P<0.001).
CONCLUSION: LDA is not efficacious in the prevention of preeclampsia in pregnant women with the risk factors studied but is useful in improving gestational age at delivery and birth weight.
RECOMMENDATIONS: LDA should be administered to pregnant women at risk of preterm delivery or low birth weight/intrauterine growth restriction. Further studies should be considered on the benefits of LDA in the prevention of complications in twin gestation because twinning is common in our environment and patients who had preeclampsia and their babies should be followed up adequately.