Preterm deliveries and progesterone levels in pregnant women attending antenatal care in a health care facility in Sokoto state, Nigeria: a preliminary study

Authors

  • Mas’ud E. Sadiq Department of Biochemistry, Usmanu Danfodiyo University, Sokoto, Nigeria
  • Aminu L. Abubakar Department of Biochemistry, Usmanu Danfodiyo University, Sokoto, Nigeria
  • Almustapha Lawal Department of Biochemistry, Usmanu Danfodiyo University, Sokoto, Nigeria
  • Alkassim H. Ahmad School of Pharmacy, University of the Western Cape, South Africa
  • Nafisa Sada Department of Biochemistry, Usmanu Danfodiyo University, Sokoto, Nigeria

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20202742

Keywords:

Antenatal, Malnutrition, Preterm delivery, Primary healthcare, Progesterone

Abstract

Background: Progesterone related complication during pregnancy is currently being viewed as one of the underlying causes of miscarriages and preterm deliveries. Progesterone assay is often neglected during routine screening in antenatal clinics (ANC) in primary health care centres in Nigeria. This study was designed to monitor 40 volunteer expecting mothers between the ages 18-35 years with a history of child birth and to evaluate serum progesterone levels accordingly for pregnancy in second and third trimesters.

Methods: Volunteers were categorized according to their age and stage of pregnancy. Progesterone was estimated in serum collected from each volunteer using ELISA kits (Cayman chemicals, USA).

Results: The results showed that age disparity among subjects did not play a role in the observed progesterone levels in both trimesters. Second trimester progesterone levels (37.73±0.32 ng/ml) were closest to lower limits of reference ranges for second trimester pregnancy (25.60-89.40 ng/ml). However, third trimester average serum progesterone levels of 36.31±0.26 ng/ml fell below minimum values of 42.50 ng/ml expected in normal pregnancy. Three preterm deliveries were recorded among the monitored subjects while an incidence rate of 1:32 births was observed for all deliveries received at the facility within the five months period all monitored subjects gave birth.

Conclusions: The preponderance of low gestational progesterone constitutes a risk factor to delivery at term. It is recommended that local ANC programme include progesterone monitoring and therapy as an intervention strategy against preterm births.

References

Delnord, M, Zeitlin J. Epidemiology of late preterm and early term births: an international perspective. In: Seminars Fetal Neonat Med. 2019;24(1):3-10.

Chawanpaiboon S, Vogel JP, Moller AB, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. The Lancet Global Health. 2019;7(1):e37-e46.

Dodd JM, Crowther CA. The role of progesterone in prevention of preterm birth. Int J Women's Health. 2009;1:73.

Di Renzo GC, Mattei A, Gojnic M, Gerli S. Progesterone and pregnancy. Current Opin Obstet Gynecol. 2005;17(6):598-600.

Nair RR, Verma P, Singh K. Immune-endocrine crosstalk during pregnancy. General Comp Endocrinol. 2017;242:18-23.

Wani JM, Sharma U, Pande N, Kumar S, Pandey AK, Kumar S. Fetus as an allograft: a review. Theriogenol Insight. 2018;8(2):87-9.

Norwitz ER, Caughey AB. Progesterone supplementation and the prevention of preterm birth. Rev Obstet Gynecol. 2011;4(2):60.

Oluwatayo BO, Ebomoyi MI, Obika LFO, Okeke LLA. Progesterone and 17ß-estradiol levels during normal pregnancy and the puerperium among women attending a tertiary health facility clinic in Jos, Plateau State, Nigeria. Int Blood Res Rev. 2016;5(1):1-7.

Haluska GJ, Cooka MJ, Novy MJ. Inhibition and augmentation of progesterone production during pregnancy: effects on parturition in rhesus monkeys. Am J Obstet Gynecol. 1997;176(3):682-91.

Mazor M, Hershkovitz R, Chaim W, Levy J, Sharony Y, Leiberman JR, et al. Human preterm birth is associated with systemic and local changes in progesterone/17β-estradiol ratios. Am J Obstet Gynecol. 1994;171(1):231-6.

Patel B, Elguero S, Thakore S, Dahoud W, BedaiwyM, Mesiano S. Role of nuclear progesterone receptor isoforms in uterine pathophysiology. Human Reprod Update. 2014;21(2):155-73.

Behrman RE, Butler AS. Biological pathways leading to preterm birth. In preterm birth: causes, consequences, and prevention. National Academies Press (US). 2007;171-180.

Kant RH, Ara S, Lone AI, Gupta S. Evaluation of outcome of pregnancy in threatened abortion by serum progesterone levels. Int J Reprod Contracept Obstet Gynecol. 2015;4(5):1313-8.

Kenny LC, Lavender T, McNamee R, O’Neill SM, Mills T, Khashan AS. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PloS One. 2013;8(2):e56583.

Khalil A, Syngelaki A, Maiz N, Zinevich Y, Nicolaides KH. Maternal age and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol. 2013;42(6):634-43.

Lean SC, Derricott H, Jones RL, Heazell AE. Advanced maternal age and adverse pregnancy outcomes: a systematic review and meta-analysis. PloS One. 2017;12(10):e0186287.

Butali A, Ezeaka C, Ekhaguere O, Weathers N, Ladd J, Fajolu I, Adeyemo W. Characteristics and risk factors of preterm births in a tertiary center in Lagos, Nigeria. Pan African Med J. 2016;24:1.

Oluwafemi RO, Abiodun MT. Incidence and outcome of preterm deliveries in mother and child Hospital Akure, Southwestern Nigeria. Sri Lanka J Child Health. 2016;45(1):11-7.

Iyoke CA, Lawani LO, Ezugwu EC, Ilo KK, Ilechukwu GC, Asinobi IN. Maternal risk factors for singleton preterm births and survival at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Nigerian J Clin Pract. 2015;18(6):744-50.

NNHS Report. Report on the Nutrition and Health Situation of Nigeria. National Bureau of Statistic; 2018:82-98.

Downloads

Published

2020-06-25

Issue

Section

Original Research Articles