Serum Calcium Levels of Pregnant Women Utilizing Antenatal Care in Primary Health Centres (PHC) in Urban and Rural Areas in Uyo Senatorial District of Akwa Ibom State
Keyukemi Ekpotu*, Uwemedimbuk Ekanem and Motilewa Olugbemi
Department of Community Medicine, University of Uyo Teaching Hospital, Nigeria
*Corresponding Author: Keyukemi Ekpotu, Department of Community Medicine, University of Uyo Teaching Hospital, Nigeria.
December 16, 2022; Published: May 19, 2023
Background: Calcium is a necessary for so many physiological processes in the body, especially during pregnancy. Insufficient calcium intake and consequent hypocalcemia poses risks to both fetus and mother including intrauterine growth restriction, low birth weight, poor bone mineralization, preterm birth, maternal hypertension, and preeclampsia. The World Health Organization recommends calcium supplementation for populations with low dietary intake of calcium which necessitates the assessment of serum calcium levels among pregnant women to determine populations that may benefit from calcium supplementation. This study, therefore, aims to compare the serum calcium levels and associated factors of pregnant women utilizing antenatal care in primary health centres (PHC) in urban and rural areas in Uyo senatorial district of Akwa Ibom State.
Methods: This study was a cross-sectional study carried out in 6 primary health care (3 urban and 3 rural) facilities in Uyo senatorial district of Akwa Ibom, selected by simple random sampling. An interviewer administered semi-structured questionnaire was used to obtain information on respondents’ characteristics, 24-hour dietary recall and dietary supplements intake. Serum ionized calcium was measured using an Ion selective electrolyte analyzer LW E60B. Descriptive statistics were presented in tables and figures. Chi square test and Fisher’s exact were performed to examine the relationship between outcome variable and respondents’ characteristics. Statistical significance was set at a p value of 0.05.
Result: A total of 180 pregnant women (90 urban and 90 rural) were enrolled into this study. The average age of respondents was 27.39 ± 4.69 years. Only 10.6% respondents reported receiving calcium supplements during the index pregnancy (rural 16.7% vs urban 4.4%; p = 0.013). However, the average 24-hour dietary protein was 1,331.6 mg (110.9% of Recommended nutrient intake [RNI]), with rural respondents having higher intake (116.0% of RNI) compared to urban respondents (107.1% of RNI). The average serum ionized calcium levels of both urban (1.251 ± 0.129) and rural (1.274 ± 0.06) respondents were within the normal range, and only 7.8% and 13.3% of rural and urban respondents respectively had hypocalcemia. Only gestational age of rural respondents showed significant association with serum ionized calcium level.
Conclusion: Majority of the pregnant women had adequate intakes of dietary calcium with rural respondents having higher intakes compared to urban respondents. And most participants had normal levels of serum ionized calcium, with the mean serum ionized calcium being slightly higher among rural respondents compared to urban respondents. We recommend that high quality controlled trials be carried out in our environment to determine the effect of calcium supplementation on maternal and fetal outcomes in our population considering the already adequate dietary calcium intake and serum calcium levels.
Keywords: Calcium; Parathyroid Hormone (PTH); Hypertension
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