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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Pulmonary Edema | Research article

Maternal and perinatal outcomes of hypertensive disorders of pregnancy in Ethiopia: systematic review and meta-analysis

Authors: Amanual Getnet Mersha, Tadesse Melaku Abegaz, Mohammed Assen Seid

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

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Abstract

Background

Hypertensive disorders of pregnancy complicate around 6% of pregnancies and accounts for 19% of maternal death in Ethiopia. The current review aimed to assess maternal and perinatal outcomes of pregnancies complicated by hypertension in Ethiopia.

Methods

A systematic review and meta-analysis was done on the outcome of hypertensive disorder among pregnant women in Ethiopia. Literature search was made in five databases and Statistical analyses were carried out by using Stata 14 software. The pooled prevalence of maternal death, HELLP syndrome, perinatal death, and low birth weight was calculated using a random-effects model. Egger’s test and funnel plot were used to evaluate publication bias. The Cochran Q test and I2 test statistics were used to test the heterogeneity of studies.

Result

Thirteen studies included in the review, with an overall sample size of 5894 women diagnosed to have hypertensive disorder of pregnancy. The pooled prevalence of maternal death was estimated to be 4% (95% CI: 2, 6%). The pooled prevalence of HELLP syndrome was 13% (95% CI: 10, 16%). Other complications such as pulmonary edema, kidney injury, hepatic injury, placental abruption, and aspiration pneumonia were also reported. Perinatal death was observed in one-fourth of women with HDP 25% (95% CI: 18, 32%). The pooled prevalence of low birth weight neonate in a woman with HDP is 37% (95% CI, 27, 48%).

Conclusions

In Ethiopia, the prevalence of perinatal and maternal mortality among pregnant women with one of the hypertensive disorders were found to be higher than rates reported from high income as well as most of the low and middle income countries. For instance, one in four of pregnancies complicated by hypertensive disorder end up in perinatal death in Ethiopia. HELLP syndrome, placental abruption, pulmonary edema, renal damage, prematurity, perinatal asphyxia, and low birth weight were also commonly reported. To improve the health outcomes of hypertensive disorders of pregnancy, it is recommended to improve utilization of maternal health service; early detection and early referral of pregnant women with hypertensive disorder; advocating policies and strategies that improves the quality of health care that a pregnant woman and her newborn receive.
Literature
1.
Oberts JM, Pearson G, Cutler J, et al. Summary of the NHLBI working group on research on hypertension during pregnancy. Hypertension. 2003;41:437–45.CrossRef
2.
Berhe AK, Kassa GM, Fekadu GA, Muche AA. Prevalence of hypertensive disorders of pregnancy in Ethiopia: a systemic review and meta-analysis. BMC Pregnancy Childbirth. 2018;18(1):34.PubMedCentralCrossRefPubMed
3.
Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367:1066–74.PubMedCrossRef
4.
Firoz T, Sanghvi H, Merialdi M, von Dadelszen P. Pre-eclampsia in low and middle income countries. Best Pract Res Clin Obstet Gynaecol. 2011;25:537–48.PubMedCrossRef
5.
Adu-Bonsaffoh K, Obed SA, Seffah JD. Maternal outcomes of hypertensive disorders in pregnancy at Korle Bu Teaching Hospital, Ghana. Int J Gynaecol Obstet. 2014;127(3):238–42.PubMedCrossRef
6.
7.
Ukah UV, De Silva DA, Payne B, Magee LA, Hutcheon JA, Brown H, et al. Prediction of adverse maternal outcomes from pre-eclampsia and other hypertensive disorders of pregnancy: a systematic review. Pregnancy Hypertens. 2018;11:115–23.PubMedCrossRef
8.
9.
Central Statistical Agency (CSA) [Ethiopia] and ICF. Ethiopia Demographic and Health Survey 2016. Addis Ababa and Rockville: CSA and ICF; 2016.
10.
Abalos E, Cuesta C, Carroli G, Qureshi Z, Widmer M, Vogel JP, Souza JP, on behalf of the WHO Multicountry Survey on Maternal and Newborn Health Research Network. Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG. 2014;121(Suppl. 1):14–24.PubMedCrossRef
11.
Roberts JM, Pearson G, Cutler J, Lindheimer M. Summary of the NHLBI Working Group on research on hypertension during pregnancy. Hypertension. 2003;41(3 I):437–45.PubMedCrossRef
12.
Nusrat N, Ahson M, Munir A. Hypertensive disorders of pregnancy; frequency, maternal and perinatal out comes. J Pakistan Army Med Corps. 2010;26(1):119–23.
13.
Yücesoy G, Ozkan S, Bodur H, et al. Maternal and perinatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: a seven year experience of a tertiary care center. Arch Gynecol Obstet. 2005;273(1):43–9.CrossRefPubMed
14.
Palatnik A, Grobman WA, Miller ES. Is a history of preeclampsia associated with an increased risk of a small for gestational age infant in a future pregnancy? Am J ObstetGynecol. 2016;215(3):355.e1.CrossRef
15.
Bramham K, Briley AL, Seed P, et al. Adverse maternal and perinatal outcomes in women with previous preeclampsia: a prospective study. Am J ObstetGynecol. 2011;204(6):512.e1.CrossRef
16.
Aabidha PM, Cherian AG, Paul E, Helan J. Maternal and fetal outcome in pre-eclampsia in a secondary care hospital in South India. J Family Med Prim Care. 2015;4(2):257–60.PubMedPubMedCentralCrossRef
17.
vonElm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9.CrossRef
18.
StataCorp L. Stata Statistical Software: Release 14. [computer program]. StataCorp LP. 2015.
19.
Huedo-Medina TB, Sánchez-Meca J, Marín-Martínez F, Botella J. Assessing heterogeneity in meta-analysis: Q statistic or I2 index? Psychol Methods. 2006;11(2):193.PubMedCrossRef
20.
21.
Gudu W, Bekele D. A prospective review of eclampsia at a regional hospital, Eastern Ethiopia: incidence, clinical correlates, management and pregnancy outcome. Ethiop Med J. 2018;56:125-132.
22.
Endeshaw G, Berhan Y. Perinatal outcome in women with hypertensive disorders of pregnancy: a retrospective cohort study. Int Schol Res Not. 2015;2015:208043.
23.
24.
Seid I, et al. Maternal outcomes of preeclampsia in an Ethiopian Gynecologic Hospital. Ann Med Health Sci Res. 2017;7:16–21.
25.
Wagnew M, Dessalegn M, Worku A, Nyagero J. Trends of preeclampsia/eclampsia and maternal and neonatal outcomes among women delivering in Addis Ababa selected government hospitals, Ethiopia: a retrospective cross sectional study. Pan Afr Med J. 2016;25(Suppl 2):12.PubMedPubMedCentral
26.
Seyom E, Abera M, Tesfaye M, Fentahun N. Maternal and fetal outcome of pregnancy related hypertension in Mettu Karl Referral Hospital, Ethiopia. J Ovarian Res. 2015;8:10.PubMedPubMedCentralCrossRef
27.
Berhan Y, Endeshaw G. Maternal mortality predictors in women with hypertensive disorders of pregnancy: a retrospective cohort study. Ethiop J Health Sci. 2015;25(1):89–98.PubMedPubMedCentralCrossRef
28.
Terefe W, Getachew Y, Hiruye A, Derbew M, Mariam DH, Mammo D, et al. Patterns of hypertensive disorders of pregnancy and associated factors at DebreBerhan referral hospital, north Shoa, Amhara region. Ethiop Med J. 2015;(Suppl 2):57–65.
29.
Wolde Z, Segni H, Woldie M. Hypertensive disorders of pregnancy in Jimma university specialized hospital. Ethiop J Health Sci. 2011;21(3):147–54.PubMedPubMedCentral
30.
31.
Selamawit D, Sisay T. Maternal and perinatal outcomes of pregenanciescomplecated by preeclampsia/eclampsia at zewditu memorial hospital. Addis Ababa Aniversity School of Graduate Studies Faculty of Medicine 2015.
32.
Abate M, Lakew Z. Eclampsia a 5 years retrospective review of 216 cases managed in two teaching hospitals in Addis Ababa. Ethiop Med J. 2006;44(1):27–31.PubMed
33.
Hossain N, Shah N, Khan N, Lata S, Khan NH. Maternal and perinatal outcome of hypertensive disorders of pregnancy at a tertiary care hospital. J Dow Univ Health Sci Karachi. 2011;5(1):12–6.
34.
Subki AH, Algethami MR, Baabdullah WM, Alnefaie MN, Alzanbagi MA, Alsolami RM, et al. Prevalence, risk factors, and fetal and maternal outcomes of hypertensive disorders of pregnancy: a retrospective study in Western Saudi Arabia. Oman Med J. 2018;33(5):409–15.PubMedPubMedCentralCrossRef
35.
Karumanchi SA, Maynard SE, Stillman IE, Epstein FH, Sukhatme VP. Preeclampsia: a renal perspective. Kidney Int. 2005;67(6):2101–13.PubMedCrossRef
36.
Steinborn A, Rebmann V, Scharf A, Sohn C, Grosse-Wilde H. Soluble HLA-DR levels in the maternal circulation of normal and pathologic pregnancy. Am J Obstet Gynecol. 2003;188:473–9.PubMedCrossRef
37.
Agatisa PK, Ness RB, Roberts JM, Costantino JP, Kuller LH, McLaughlin MK. Impairment of endothelial function in women with a history of preeclampsia: an indicator of cardiovascular risk. Am J Physiol Heart Circ Physiol. 2004;286:H1389–93.PubMedCrossRef
38.
Ahmad A, Samuelsen S. Hypertensive disorders in pregnancy and fetal 371° 121° death at different gestational lengths: a population study of 2 pregnancies. BJOG. 2012;119:1521–8.PubMedCrossRef
39.
Browne JL, Vissers KM, Antwi E, Srofenyoh EK, Van der Linden EL, Agyepong IA, et al. Perinatal outcomes after hypertensive disorders in pregnancy in a low resource setting. Trop Med Int Health. 2015;20(12):1778–86.PubMedCrossRef
40.
41.
Ronsmans C, Campbell O. Quantifying the fall in mortality associated with interventions related to hypertensive diseases of pregnancy. BMC Public Health. 2011;11(3):S8.PubMedPubMedCentralCrossRef
Metadata
Title
Maternal and perinatal outcomes of hypertensive disorders of pregnancy in Ethiopia: systematic review and meta-analysis
Authors
Amanual Getnet Mersha
Tadesse Melaku Abegaz
Mohammed Assen Seid
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2617-8

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