Burden, risk factors, and maternal postpartum and birth outcomes of hypertensive disorder of pregnancy in Ethiopia, 2024: A systematic review and meta-analysis.

Abstract

Objectives: This review aimed to report the estimated pooled level of prevalence, risk factors, and birth outcome of hypertensive disorder of pregnancy in Ethiopia, in 2024.

Design: A systematic review and meta-analysis approach was utilized.

Data sources and methods: PubMed/MEDLINE, Google Scholar, African Index Medicus, Web of Science, and CINHAL (EBSCO) search was carried out. The result was written according to the PRISMA-updated guidelines. To estimate the pooled prevalence and effect sizes, a random-effect model was used. Heterogeneity was assessed and investigated using I ² test statistics and meta-regression, respectively. Publication bias was assessed using funnel plot and Egger's test statistics. Statistical tests result at p-value < 0.05 were declared as having significance.

Result: From a total of 52 primary studies with a total sample size of 269, 158 were included in this systematic review and meta-analysis. The pooled prevalence of hypertensive disorder in pregnancy was 8%. Egger's test statistics (p = 0.8013) showed there is no publication bias. Having a history of kidney disease (AOR: 3.47), being rural resident (AOR: 2.5), having fruit intake during pregnancy (AOR: 0.39), being overweight (AOR: 2.24), and having multiple pregnancy (AOR: 2.1) were found to have a significant association with hypertensive disorder of pregnancy.

Conclusion: Overall, the level of prevalence of hypertensive disorders of pregnancy in Ethiopia was significantly increasing. Having a history of kidney disease was found to have a strong association with hypertensive disorders of pregnancy among factors. The most common or dominant adverse maternal and childbirth outcomes were low birth weight, preterm birth, fifth minute low APGAR score; and eclampsia, hemolysis, elevated liver enzymes, and low platelets syndrome, and acute kidney injury. The governments and other stakeholders should work to broaden and strengthen the existing maternal and child health (MCH) practice by incorporating all possible risk factors of hypertensive disorders of pregnancy in MCH guidelines. In addition, a large-scale study is required that considers those important missed variables, especially, in the eastern part of Ethiopia.