Aisha Abdurrahman, Aisha Nana Adamu, Adewale Ashimi, Oguntayo O. Adekunle, Stephen B. Bature, Labaran D. Aliyu, Owodunni Akeem, Hauwa Abdullahi, Tina Lavin, Sulaiman Daneji, Basiru Musa, Zulkiflu Muazu, Jamilu Tukur, Hadiza Shehu Galadanci
{"title":"Predictors, prevalence and outcome of hypertensive disorders in pregnancy in Nigerian tertiary health facilities","authors":"Aisha Abdurrahman, Aisha Nana Adamu, Adewale Ashimi, Oguntayo O. Adekunle, Stephen B. Bature, Labaran D. Aliyu, Owodunni Akeem, Hauwa Abdullahi, Tina Lavin, Sulaiman Daneji, Basiru Musa, Zulkiflu Muazu, Jamilu Tukur, Hadiza Shehu Galadanci","doi":"10.1111/1471-0528.17902","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>Determine prevalence, risk factors and outcomes of hypertensive disorders in pregnancy (HDP).</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Cross-sectional analysis of data captured in the Maternal and Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) between September 2019 and August 2020.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>Fifty-four referral level facilities in Nigeria.</p>\n </section>\n \n <section>\n \n <h3> Population</h3>\n \n <p>Women whose pregnancy ended (irrespective of the location or duration of pregnancy) or who were admitted within 42 days of delivery.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Descriptive statistics and multilevel mixed-effects logistic regression models.</p>\n </section>\n \n <section>\n \n <h3> Main Outcome Measures</h3>\n \n <p>Prevalence of HDP, sociodemographic and clinical factors associated with HDP and perinatal outcomes.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among the 71 758 women 6.4% had HDP and gestational hypertension accounted for 49.8%. Preeclampsia and eclampsia were observed in 9.5% and 7.0% of all pregnancies, respectively. The predictors of HDP were age over 35 years (OR1.96, 95% CI 1.82–2.12; <i>p</i> < 0.001), lack of formal educational (OR 1.18, 95% CI 1.06–1.32; <i>p</i> = 0.002), primary level of education (OR 1.20, 95% CI 1.03–1.4; <i>p</i> < 0.002), nulliparity (OR 1.21, 95% CI 1.12–1.31; <i>p</i> < 0.001), grand-multiparity (OR 1.36, 95%CI 1.21–1.52; <i>p</i> < 0.001), previous caesarean section (OR 1.26, 95%CI 1.15–1.38; <i>p</i> < 0.001) and previous miscarriage (OR 1.22, 95% CI 1.13–1.31; <i>p</i> < 0.001). Overall 3.7% of the patients with HDP died, with eclampsia having the highest case fatality rate of 27.9%. Stillbirth occurred in 11.9% of pregnancies with hypertensive disorders.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Hypertensive disorders in pregnancy are not uncommon in Nigeria. They are associated with adverse outcomes with over one-quarter of women with eclampsia dying. The main predictors include older age, poor education, extremes of parity and previous CS or miscarriage. Maternal and perinatal outcomes are poor with about a quarter developing complications and about 1 in 10 having stillbirths.</p>\n </section>\n </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7000,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17902","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bjog-An International Journal of Obstetrics and Gynaecology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/1471-0528.17902","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
Determine prevalence, risk factors and outcomes of hypertensive disorders in pregnancy (HDP).
Design
Cross-sectional analysis of data captured in the Maternal and Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) between September 2019 and August 2020.
Setting
Fifty-four referral level facilities in Nigeria.
Population
Women whose pregnancy ended (irrespective of the location or duration of pregnancy) or who were admitted within 42 days of delivery.
Methods
Descriptive statistics and multilevel mixed-effects logistic regression models.
Main Outcome Measures
Prevalence of HDP, sociodemographic and clinical factors associated with HDP and perinatal outcomes.
Results
Among the 71 758 women 6.4% had HDP and gestational hypertension accounted for 49.8%. Preeclampsia and eclampsia were observed in 9.5% and 7.0% of all pregnancies, respectively. The predictors of HDP were age over 35 years (OR1.96, 95% CI 1.82–2.12; p < 0.001), lack of formal educational (OR 1.18, 95% CI 1.06–1.32; p = 0.002), primary level of education (OR 1.20, 95% CI 1.03–1.4; p < 0.002), nulliparity (OR 1.21, 95% CI 1.12–1.31; p < 0.001), grand-multiparity (OR 1.36, 95%CI 1.21–1.52; p < 0.001), previous caesarean section (OR 1.26, 95%CI 1.15–1.38; p < 0.001) and previous miscarriage (OR 1.22, 95% CI 1.13–1.31; p < 0.001). Overall 3.7% of the patients with HDP died, with eclampsia having the highest case fatality rate of 27.9%. Stillbirth occurred in 11.9% of pregnancies with hypertensive disorders.
Conclusions
Hypertensive disorders in pregnancy are not uncommon in Nigeria. They are associated with adverse outcomes with over one-quarter of women with eclampsia dying. The main predictors include older age, poor education, extremes of parity and previous CS or miscarriage. Maternal and perinatal outcomes are poor with about a quarter developing complications and about 1 in 10 having stillbirths.
期刊介绍:
BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.