Nigerian medical journal : journal of the Nigeria Medical Association最新文献

{"title":"Association Between Transport Cost Burden, Basic Health Care Provision Fund (BHCPF) Enrolment, And Completion of Four Or More Antenatal Care Visits Among Pregnant Women in Ilorin South Local Government Area, Kwara State, Nigeria: A Mixed-Methods Study.","authors":"Mark-Adewunmi Ayodeji Adedeji, Mustapha Kwe Manga, Nkiru Jane Membis, Tsintop Mathias, Divine Ega Mfam, Idris Muhammad Yakubu","doi":"10.71480/nmj.v67i5.1561","DOIUrl":"10.71480/nmj.v67i5.1561","url":null,"abstract":"<p><strong>Background: </strong>Antenatal care reduces maternal mortality, yet completion of the recommended minimum of four visits remains suboptimal in Nigeria. High transportation cost is a persistent enabling barrier, while the Basic Health Care Provision Fund (BHCPF) is an enabling financial resource; their interaction has not previously been examined.</p><p><strong>Methodology: </strong>A convergent mixed-methods study was conducted among pregnant and postpartum women in Ilorin South Local Government Area, Kwara State. Quantitative data from a facility-based survey (n=521) were analysed using chi-square tests and binary logistic regression with a transport-cost-burden × BHCPF-enrolment interaction term. Qualitative data from 14 in-depth interviews were analysed using thematic framework analysis.</p><p><strong>Results: </strong>Overall, 271 respondents (52.0%) completed four or more ANC visits. Transport cost burden was independently and negatively associated with completion (adjusted odds ratio [AOR]=0.84 per ₦100, p<0.001), while BHCPF enrolment was independently and positively associated with completion (AOR=1.98, p<0.001). The interaction term was significant and positive (AOR=1.29, p=0.021), showing that BHCPF enrolment moderated the adverse effect of transport cost on completion. Qualitative themes showed that women practised \"transport rationing\" as a coping strategy, and that BHCPF operated as an indirect transport subsidy by freeing household income otherwise spent on consultation and drug costs.</p><p><strong>Conclusion: </strong>BHCPF enrolment partially offsets the adverse effect of transport cost burden on ANC completion. Policymakers should consider linking BHCPF enrolment more explicitly to direct transport support, particularly for peri-urban populations.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1819-1827"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Diabetes Mellitus among Adults in Rural Anambra State, Nigeria: Cross-Sectional Study.","authors":"Chidozie Ndubisi Ndulue, Oluchi Isioma Ndulue, Chinweokwu Godfrey Attama, Tobenna Chinweizu Ndulue, Jideofor Kenechi Ndulue","doi":"10.71480/nmj.v67i5.1302","DOIUrl":"10.71480/nmj.v67i5.1302","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of Diabetes Mellitus (DM) has increased rapidly in Nigeria, but studies show that DM prevalence varies in different parts of Nigeria. Despite the documented burden of chronic DM complications in Anambra State, the community-based prevalence of DM among adults in Anambra State is unknown. To determine the prevalence of DM in a rural community in Anambra State, Nigeria.</p><p><strong>Methodology: </strong>Multistage cluster sampling technique was used to select adult residents of Ukpor aged ≥ 18 years. Data was collected using the STEPwise approach to chronic disease surveillance questionnaire. Diabetes Mellitus was defined as either random blood glucose ≥ 11 mmol/L, or previous diagnosis of DM. Data obtained was analysed using the T-test and Chi-square test. P-value < 0.05 was regarded as statistically significant.</p><p><strong>Results: </strong>The prevalence of DM was 12.3%. The prevalence of DM increased with age, and the association between increasing age and DM was significant (p < 0.05). Although the prevalence of DM was higher in women (14.1%) than in men (9.2%), there was no significant association between sex and DM (p > 0.05).</p><p><strong>Conclusion: </strong>The prevalence of DM among adults in this community is high and corresponds with the high burden of chronic DM complications previously documented in Anambra State.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1828-1835"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern and Outcome of Congenital Anomalies Seen in the Newborn Unit of a Tertiary Hospital in North-East Nigeria.","authors":"Wasinda Solomon Bulus, Fatimah Joy Baba, Solomon Gideon Bulus, Mustapha Bello","doi":"10.71480/nmj.v67i5.1436","DOIUrl":"10.71480/nmj.v67i5.1436","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies (CAs) are structural, functional, or metabolic abnormalities present at birth and are major contributors to foetal loss, neonatal morbidity, and mortality. Their occurrence is influenced by genetic and environmental factors, and their prevalence varies across regions. This study determined the proportion, pattern, and outcomes of congenital anomalies among neonates admitted to Modibbo Adama University Teaching Hospital, Yola.</p><p><strong>Methodology: </strong>A five-year retrospective review (January 2021-December 2025) of neonates with congenital anomalies admitted to the newborn unit of a tertiary hospital in North-East Nigeria was conducted. Data on neonatal and maternal characteristics, types of congenital anomalies, and treatment outcomes were extracted from medical records and analyzed using IBM SPSS version 25. Descriptive statistics summarized the data, while Chi-square tests and multivariable logistic regression identified factors associated with neonatal mortality. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Of 5,116 neonatal admissions, 581 (11.4%) had congenital anomalies, and 520 with complete records were included in the analysis. Males accounted for 60.2% of cases (male-to-female ratio 1.5:1). Gastrointestinal anomalies were the most common (55.0%), followed by central nervous system anomalies (28.5%). Spina bifida (22.3%) and anorectal malformation (17.1%) were the leading specific anomalies. Overall, 58.1% of neonates were discharged, 26.9% died, and 15.0% were discharged against medical advice.</p><p><strong>Conclusion: </strong>Congenital anomalies constitute a substantial burden among neonatal admissions in our setting and are associated with high mortality. Strengthening antenatal care, promoting early diagnosis, ensuring timely referral, and improving access to specialized neonatal and surgical services are essential to improving outcomes.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1763-1779"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Congenital Anomalies in Low-Risk Pregnancies in Zaria, Nigeria.","authors":"Mubarak Zubair Abdullahi, Bashir Dagauda Garba, Nafisa Bello, Rabiu Musa, Jamilu Ahmad","doi":"10.71480/nmj.v67i5.1508","DOIUrl":"10.71480/nmj.v67i5.1508","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies are a major cause of perinatal morbidity and mortality worldwide. Although prenatal ultrasonography is the primary method for detecting structural fetal anomalies, evidence on their prevalence among low-risk pregnancies in Nigeria remains limited. The objective of this study is to determine the sonographic prevalence of congenital fetal anomalies among low-risk pregnant women attending antenatal clinics in Zaria, Northwestern Nigeria.</p><p><strong>Methodology: </strong>This hospital-based cross-sectional study was conducted between March and September 2024 among 570 low-risk pregnant women attending Ahmadu Bello University Teaching Hospital, Kofar Gaya General Hospital, and the University Health Services (Sick Bay), Zaria. Participants underwent routine second-trimester fetal anomaly scans following standardized ultrasound protocols. Data were analysed using descriptive statistics, and the prevalence of congenital anomalies was calculated with 95% confidence intervals.</p><p><strong>Results: </strong>The mean maternal age was 26.0 ± 5.1 years, while the mean gestational age at ultrasound examination was 21.2 ± 2.2 weeks. Eight fetuses were diagnosed with congenital anomalies, giving an overall prevalence of 1.4% (95% CI: 0.6-2.8%). Central nervous system anomalies were the most common abnormalities, followed by cardiac and urogenital anomalies. Some affected fetuses had anomalies involving more than one organ system.</p><p><strong>Conclusion: </strong>Congenital fetal anomalies occur even among pregnancies considered clinically low risk. These findings support routine second-trimester fetal anomaly screening for all pregnant women to facilitate early diagnosis, appropriate counselling, and timely obstetric management.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1794-1800"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Genome Engineering in Human Disease: Expanding Therapeutic Roles of CRISPR Technologies.","authors":"Abraham Ehinomhen Ubhenin, Fatima Adis Adamude, Dickson Owoicho Ochalefu, Fatimah Anura, Clement Iorhembe Tarnande, Ibrahim Khalil Adam","doi":"10.71480/nmj.v67i5.1313","DOIUrl":"10.71480/nmj.v67i5.1313","url":null,"abstract":"<p><p>The advent of CRISPR-Cas9 technology has revolutionized genome editing, enabling precise modifications to the human genome with unprecedented accuracy and sequence specificity. This review examines current mechanistic insights, translational advances, and clinical developments in gene editing, focusing on applications in diabetes mellitus, cancer, hematologic disorders, neurodegenerative diseases, and autoimmune pathologies. This study provides a comprehensive analysis of recent literature on CRISPR-based genome editing, emphasizing next-generation modalities like base editing and prime editing, and their impact on target specificity and genomic integrity. Therapeutic strategies involving ex vivo editing of hematopoietic stem cells and in vivo delivery approaches, including lipid nanoparticle-mediated systems, are evaluated. Base editing and prime editing have improved sequence specificity and reduced double-strand DNA breaks, enhancing safety profiles. Ex vivo editing of hematopoietic stem cells for hemoglobinopathies and in vivo genome editing via lipid nanoparticles show translational promise. However, limitations persist: off-target effects, immunogenicity, delivery inefficiencies, and ethical concerns surrounding germline editing require careful consideration. Gene editing technologies show potential for treating previously intractable diseases. Technical, safety, and ethical challenges must be addressed through continued refinement of editing platforms, rigorous scientific validation, and the establishment of robust governance frameworks to ensure safe and responsible translation into clinical medicine.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1720-1728"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Study of Early Versus Delayed Appendicectomy in the Treatment of Acute Appendicitis at Jos University Teaching Hospital.","authors":"Vincent Abah Abutu, Moses Ahangba Adamgbe, Iorwuese Joshua Agbatse, Joshua Adejo Okpanachi, John Adole Inalegwu, Jack Oloche Okopi, Kingsley Emeka Onuh, Augustine Z Sule","doi":"10.71480/nmj.v67i5.1142","DOIUrl":"10.71480/nmj.v67i5.1142","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is a common surgical emergency in Nigeria, with early appendicectomy traditionally regarded as the standard treatment to minimize complications. However, the optimal timing of surgery remains controversial. This study aimed to compare the peri-operative outcomes of early versus delayed appendicectomy in patients with acute appendicitis, thereby assessing whether surgical timing influences clinical outcomes and determining the approach associated with better peri-operative results.</p><p><strong>Methodology: </strong>This was a prospective randomized controlled study carried out at the Jos University Teaching Hospital. Patients were randomized into an early (within 12 hours of presentation) and delayed (up to 24 hours) appendicectomy groups. Their 30-day post-operative outcome was analysed using SPSS Version 25.</p><p><strong>Results: </strong>Fifty-six participants (28 on each arm) completed the study. Surgical site infection developed in 3 (10.7%) and 2 (7.1%) patients from the early and late appendicectomy groups, respectively (p = 1). There was no statistically significant difference in the perforation rate, cost of care or length of hospital stay between the two groups. No mortality was recorded.</p><p><strong>Conclusion: </strong>This study showed no statistically significant difference between the outcome of patients who had early appendicectomy and that of those who had delayed appendicectomy. Hence, appendicectomy for acute appendicitis can be safely delayed for up to 24 hours from diagnosis, provided the patients are promptly commenced on antibiotics.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1742-1751"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revascularization Gaps in Diabetic Foot Disease in Nigeria: Health-System Constraints and the Need for a National Limb-Salvage Strategy.","authors":"Oladimeji Adedeji Junaid","doi":"10.71480/nmj.v67i5.1682","DOIUrl":"10.71480/nmj.v67i5.1682","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulceration remains a major cause of non-traumatic lower-limb amputation, disability, prolonged hospitalisation and excess mortality. Nigerian studies document substantial burdens of ulceration, late presentation and amputation, but national data on vascular assessment, referral and revascularization remain limited.</p><p><strong>Methodology: </strong>PubMed/MEDLINE, Google Scholar and African Journals Online, together with relevant guideline, epidemiology, health-financing and programme websites, were searched from inception to 15 July 2026. Approximately 250 potentially relevant records were identified; about 74 full-text articles, guidelines and policy documents were assessed, and 36 sources were retained for thematic synthesis. Nigerian evidence was prioritised. Selection considered direct relevance, methodological clarity and contribution to prespecified clinical and health-system themes; no formal risk-of-bias instrument or meta-analysis was used.</p><p><strong>Results: </strong>The available literature is consistent with a probable, but currently unquantified, revascularization gap within Nigerian diabetic-foot services. Potential contributors include delayed recognition of peripheral arterial disease (PAD), inconsistent objective perfusion assessment, scarce and geographically concentrated vascular expertise, limited imaging and procedural infrastructure, fragmented referral pathways and high out-of-pocket costs. Revascularization remains the central focus of this review because restoration of perfusion is indispensable when ischaemia threatens healing; however, it is one component of comprehensive multidisciplinary care in diabetic foot disease.</p><p><strong>Conclusion: </strong>Nigeria should strengthen objective vascular assessment and timely access to revascularization within an integrated limb-salvage pathway that also prioritises infection control, offloading, glycaemic and cardiovascular risk optimisation, wound care, nutrition, smoking cessation and rehabilitation. National data systems are needed to quantify service gaps and evaluate outcomes.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1691-1702"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Sleep Quality and Resting Heart Rate with Academic Performance among Preclinical Medical Students at Yobe State University, Damaturu, Nigeria.","authors":"Isyaku Gwarzo Mukhtar, Ahmad Jibrin Barde","doi":"10.71480/nmj.v67i5.1419","DOIUrl":"10.71480/nmj.v67i5.1419","url":null,"abstract":"<p><strong>Background: </strong>Sleep plays a vital role in cognitive function, emotional regulation, and cardiovascular health. Medical students are vulnerable to poor sleep quality, which may adversely affect their academic performance. The aim of the study was to assess the relationship between sleep quality and resting heart rate with academic performance among medical students at Yobe State University, Damaturu, Nigeria.</p><p><strong>Methodology: </strong>A cross-sectional analytical study design was used to consecutively recruit 100 preclinical medical students. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, while academic performance was assessed using the Grade Point Average (GPA). Resting heart rate was measured using a validated digital heart rate monitor. Data were analyzed using an independent samples t-test, Pearson's correlation, and multiple linear regression. Statistical significance was set at p ≤ 0.05.</p><p><strong>Results: </strong>Mean age of the participants was 23.88 ± 2.61 years (18-30 years). Thirty-six percent of participants had poor sleep quality. Participants with good sleep quality demonstrated significantly lower resting heart rate (p = 0.016) and higher GPA (p = 0.003) compared to those with poor sleep quality. Sleep duration (p = 0.004) and sleep efficiency (p = 0.002) were positively correlated with GPA, while resting heart rate was negatively correlated with GPA (p = 0.010). However, neither sleep indices nor resting heart rate predicted GPA after controlling for age, sex, and level of study.</p><p><strong>Conclusions: </strong>While good sleep quality and lower resting heart rate were associated with better GPA on bivariate analysis, neither independently predicted GPA on multivariate regression, highlighting the multifactorial nature of academic performance.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1886-1894"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco Use and Motivation to Quit Among Pregnant Women: An Institutional Observational Study from Western Rajasthan.","authors":"Neha Garg, Surendra Singh Rajpurohit, Balgopal Singh Bhati, Nooren Mirza, Sanyam Tyagi, Shivani Gupta, Ankit Awasthi, Navratan Suthar","doi":"10.71480/nmj.v67i5.1507","DOIUrl":"10.71480/nmj.v67i5.1507","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use during pregnancy remains an important public health issue, especially in regions where smokeless tobacco is prevalent. Evidence on tobacco use patterns and motivation to quit among pregnant women is limited. The objective of this study is to assess the prevalence and pattern of tobacco use, motivation to quit, and their association with socio-demographic and clinical factors, among pregnant women attending a tertiary care centre in Western Rajasthan.</p><p><strong>Methodology: </strong>A hospital-based cross-sectional study using convenience sampling was conducted among 487 pregnant women attending a tertiary care antenatal clinic. Nicotine dependence was assessed using the Fagerström Test for Nicotine Dependence, and readiness to change using the transtheoretical model. Non-parametric tests, multivariable binary logistic regression, and multinomial logistic regression were used for analysis.</p><p><strong>Results: </strong>Tobacco use prevalence was 11.5%. Tobacco use was significantly more common among women with lower education, rural residence, semi/unskilled occupations, grand multiparity, and unplanned pregnancies. Advancing gestational age was associated with a greater likelihood of abstinence. Among active users, nearly two-thirds were in the precontemplation or contemplation stage, indicating low readiness to quit. Motivation to quit was significantly associated with FTND scores (H = 31.25, p = 0.005).</p><p><strong>Conclusions: </strong>Tobacco use during pregnancy was relatively common, with higher education associated with lower use. Culturally appropriate awareness and cessation counselling during antenatal care may improve maternal and fetal outcomes.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1780-1793"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory Mediators in the Pathway from Breastfeeding Difficulty to Postpartum Depression: A Systematic Review Following Moose Guidelines.","authors":"Zainab Mohammed Abdullahi, Sagiru Muhammad Abdu, Abubakar Ibrahim Bura, Rukayyat Muhammad Abdul","doi":"10.71480/nmj.v67i5.1540","DOIUrl":"10.71480/nmj.v67i5.1540","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding difficulty, particularly pain and mastitis, has been consistently associated with an increased risk of postpartum depression (PPD). Emerging evidence suggests that systemic inflammation may mediate this relationship, but the extent and consistency of this pathway remain unclear. The study objective is to systematically review observational studies examining the role of inflammatory biomarkers (IL-6, CRP, TNF-α, and IL-1β) in the association between breastfeeding difficulty (pain, mastitis, or cessation) and postpartum depressive symptoms.</p><p><strong>Methodology: </strong>Following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, we searched PubMed, Web of Science, PsycInfo, CINAHL, and Scopus from inception to July 2026. Observational studies assessing breastfeeding-related factors, inflammatory markers measured in biological fluids during the postpartum period (≤ 6 months), and standardized depression measures were included. Quality was assessed using the Newcastle-Ottawa Scale. Due to high heterogeneity, a narrative synthesis was performed.</p><p><strong>Results: </strong>Twelve studies met inclusion criteria (N=2,847 postpartum women). IL-6 was the most consistently elevated biomarker among women with breastfeeding difficulty and concurrent depressive symptoms, with 7 of 9 studies reporting significant positive associations. CRP showed mixed findings (4 of 8 studies significant). TNF-α and IL-1β demonstrated weaker or inconsistent associations. Mastitis was associated with the most pronounced inflammatory responses and the strongest depression correlations. Breastfeeding cessation due to pain was consistently linked to elevated IL-6 and higher EPDS scores across 5 longitudinal studies.</p><p><strong>Conclusions: </strong>Evidence supports IL-6 as a potential mediator between breastfeeding difficulty and PPD, though substantial heterogeneity in study design, biomarker timing, and depression assessment limits pooled analysis. Standardized methodologies and prospective studies with repeated biomarker measures are urgently needed to establish causal pathways and inform prevention strategies.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 5","pages":"1684-1690"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}