BackgroundEarly adolescent sexual activity remains a recurring problem with negative psychosocial and health outcomes. The age at sexual debut varies from place to place and among different individuals and is associated with varying factors. The aim was to determine the prevalence and risk factors of early sexual debut among secondary school students in Ido-Ekiti, South-West Nigeria.MethodologyThis was a cross-sectional study. The respondents were selected using multi-stage sampling technique. Pre-tested, semi-structured, self-administered questionnaire was used to collect data. Data was analyzed using SPSS version 15.ResultsMore than two-thirds, 40(67.8%), had early sexual debut. The prevalence of early sexual debut was about 11%. The mean age of sexual debut was 13.10±2.82; the mean age for early sexual debutants was 11.68±1.98. The mean number of sexual partners was 2.44±1.99. Male gender, having friends who engaged in sexual activities had association with early sexual exposure (p<0.05). Alcohol intake had the strongest strength of association for early sexual debut among the students.ConclusionThe high prevalence of early sexual exposure among the students calls for urgent interventions to stem the trend. This will help to reduce the devastating negative psycho-social and health sequels.

BACKGROUND: Globally, unplanned pregnancy and sexually transmitted infections (STIs) persist as a significant threat to women's reproductive health. In Nigeria, despite huge resources committed to family planning programs by stakeholders, contraceptive use has been very low. This study aimed at unraveling the barriers to the use of modern contraceptives among women of reproductive age (15-49 years) in Ise-Ekiti community, Ekiti State, Southwest Nigeria. METHODS: This study was a cross sectional study among women aged 15-49 years. A multi-stage sampling technique was used in the recruitment of respondents from the community. An interviewer-administered questionnaire was used to collect data. Data were analyzed using SPSS version 15. RESULTS: Although contraceptive awareness among respondents was high 496(98.6%), only 254 of the 503 respondents were using modern contraceptive methods giving a Contraceptive Prevalence Rate (CPR) of 50.5%. Among those not using any form of contraceptives, some identifiable barriers to contraceptive use includes desire for more children, 62(39.5%), partner disapproval, 40(25.5%), and fear of side-effects, 23(14.6%). Factors associated with contraceptive uptake include marital status (p=0.028), educational level (p=0.041) and religion (p=0.043) with traditional worshippers having the least uptake. CONCLUSION: This study showed that awareness to modern forms of contraceptives does translate into use. The identified barriers to contraceptive uptake suggest the need to improve uptake of contraceptives through a community-based and culturally acceptable intervention as doing this will go a long way in addressing some of these barriers. KEYWORD: Contraceptives uptake, barriers, women of reproductive age

Introduction: As many Americans are becoming overweight or obese, increased body mass index (BMI) is fast becoming normalized. There is a need for more research that highlights the association between prepregnancy obesity and adverse pregnancy outcomes.Aim: To determine the association between increasing pre-pregnancy BMI and adverse pregnancy outcomes.Methods: We utilized the United States Vital Statistics records to collate data on all childbirths in the United States between 2015 and 2019. We determined the association between increasing pre-pregnancy BMI and adverse pregnancy outcomes using multivariate analysis. Neonatal outcomes measures include the fiveminute Apgar score, neonatal unit admission, neonates receiving assisted ventilation > six hours, neonatal antibiotics use, and neonatal seizures. Maternal outcomes include cesarean section rate, mothers requiring blood transfusion, unplanned hysterectomy, and intensive care unit admission. In addition, we controlled for maternal parameters such as race/ethnicity, age, insurance type, and pre-existing conditions such as chronic hypertension and prediabetes. Other covariates include paternal race, age and education level, gestational diabetes mellitus, induction of labor, weight gain during pregnancy, gestational age at delivery, and delivery weight.Results: We studied 15,627,572 deliveries in the US Vital Statistics records between 2015 and 2019. Among these women, 3.36% were underweight, 43.19% were with a normal BMI, 26.34% were overweight, 14.73% were in the obese class I, 7.23% were in the obese class II, and 5.14% were in the obese class III. Increasing pre-pregnancy BMI was associated with significant adverse outcomes across all measures of maternal and neonatal outcomes. Conclusion:A strong association exists between increasing pre-pregnancy BMI and adverse maternal and neonatal outcomes. The higher risk of adverse pregnancy outcomes among overweight and obese women remained even after controlling for other traditional risk factors of adverse maternal and neonatal outcomes.

Introduction: Fetal macrosomia is defined as a fetal weight of more than 4kg or 4.5 kg irrespective of gestational age at delivery. The mode of delivery is usually left to the surgeon's discretion, but fetal macrosomia increases the risk of cesarean delivery among women worldwide. In addition, the role of social determinants of health such as maternal race, educational level, and insurance in managing fetal macrosomia cannot be overemphasized.Aim: To determine the interaction between maternal race, insurance, and education level and how this affects the management of fetal macrosomia in the United States.

Objective: The objective is to determine the association between maternal race/ethnicity, insurance, education level, and pregnancy outcomes. Methods: We queried the U.S. vital statistics records from 2015 to 2019 to analyze all deliveries. Using a multivariate analysis model, we determined the interaction between maternal race, insurance, education, and pregnancy outcomes. The outcome measures were the 5-min Apgar score, neonatal unit admission, neonates receiving assisted ventilation > 6 hours, mothers requiring blood transfusion, and the intensive care unit admission. Result: There were 13,213,732 deliveries that met our inclusion criteria. In the study population, 52.7% were white, 14.1% blacks, 22.9% Hispanics, and 10.4% belonged to other races. 37.5% of the women had a high school education, 49.1% had a college education, and 12.3% had advanced degrees. Black mothers with high school education were more likely to require blood transfusion following delivery than Whites at the same education level, OR=1.08 (95% CI 1.05-1.11, p < 0.05). They were also more likely to be admitted into intensive care. The difference only disappeared among blacks with advanced education (OR=1.0; 95% CI 0.89-1.12, p > 0.05). Across all races/ethnicities, private insurance and advanced education were associated with better pregnancy outcomes. Conclusion: In the U.S., women with high socioeconomic status have better pregnancy outcomes across all races/ethnicities.