Prevalence and Pattern of Pigmentary Changes among Primigravidae Attending a Tertiary Health Facility in South-Western Nigeria

Abstract

Background: Pigmentary skin changes are common presentation among pregnant women. The impact of which is very worrisome. Most of these pigmentary changes were due to increase hormonal influence such as melanocyte stimulating hormone, adrenocorticotrophic hormone, cortisol, progesterone and increased sensitivity of melanocyte at normally pigmented areas. Objective: The study was aimed at documenting the prevalence and pattern of pigmentary changes as well as providing baseline data among pregnant women in Nigeria. Materials and Methods: This study was a descriptive cross-sectional study of 240 primigravidae who attended antenatal clinic of Obafemi Awolowo University Teaching Hospitals’ Complex (OAUTHC), Ile-Ife, Nigeria and 240 controls who were never pregnant. The study was carried out between March, 2013 and March, 2014. Data was analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0. Data were presented in tables and statistical significance (measured as P<0.05) were determined using Chi square and Friedman’s tests as appropriate. Results: The general prevalence of pigmentary changes in pregnancy among the subjects in this study was 77.5% in first trimester, 95.8% in second and 95.4% in third trimesters while it was 17.1% in the controls. Nipple, areola, generalized hyperpimentations and linea nigra were much higher than controls. These pigmentary changes also increased in prevalence as pregnancy advanced. There was statistically significant association between gestational age (trimester) and pigmentary changes (P=0.000). The prevalence of melasma increases as the pregnancy progresses from 5.0% in first trimester to 8.8% in third trimester. The relationship was found to be statistically significant (P=0.000). Conclusion: The prevalence of pigmentary changes among pregnant women in Nigeria was found to be very high. Healthcare workers involved in obstetric care need to be well informed to enable accurate diagnosis and education of patients. The effects of pigmentary changes on quality of life may further be elucidated with further studies.