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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2020

01-12-2020 | Hypertension | Research article

Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study

Authors: Abadi Kidanemariam Berhe, Abiodun O. Ilesanmi, Christopher O. Aimakhu, Afework Mulugeta

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

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Abstract

Background

The prevalence of pregnancy-induced hypertension in Ethiopia ranges from 2.2 to 18.3%. However, so far little is known about the adverse perinatal outcomes of pregnancy-induced hypertension in Tigray regional state, Ethiopia. Therefore, the objective of this study was to assess the effect of pregnancy-induced hypertension on adverse perinatal outcomes in Tigray Regional State, Ethiopia.

Methods

a prospective cohort study was conducted on a total sample of 782 pregnant women attending antenatal care in hospitals of Tigray regional state, Ethiopia. Pregnant mothers diagnosed with PIH during the data collection period in the selected hospitals were included as exposed group and normotensive women were also enrolled as a control group. This study addresses women diagnosed with preeclampsia, eclampsia and gestational hypertension between 28 and 35 weeks of gestation. Data were collected using an interviewer-administered questionnaire and review of their medical records from February 2018, to February 2019. The adverse perinatal outcome event includes low birth weight, birth asphyxia, small for gestational age, preterm delivery, admission to neonatal intensive care unit and perinatal death. A modified Poisson regression model with robust standard errors was used to analyze relative risk.

Results

In this study, the overall incidence of adverse perinatal outcome was higher among women with pregnancy-induced hypertension than normotensive women (66.4% vs 22.2%). After adjusted for confounders women with pregnancy-induced hypertension were born babies with a higher risk of low birth weight (adjusted RR (95%CI) = 5.1(3.4,7.8)), birth asphyxia (aRR = 2.6(1.9,3.8)), small for gestational age (aRR = 3.3(2.3,4.6)), preterm delivery (aRR = 5.2(3.4,7.9)), stillbirth (aRR = 3.46(1.40,8.54)), admission to neonatal intensive care unit (aRR = 5.1(3.1,8.4)) and perinatal death (aRR = 3.6(1.8,7.4)) compared to normotensive pregnant women.

Conclusions

Higher incidences of adverse perinatal outcomes occurred among women pregnancy-induced hypertension in Tigray regional state, Ethiopia. Hence, health care providers should strengthen prevention, early diagnosis and prompt management of pregnancy-induced hypertension to reduce adverse perinatal outcomes of pregnancy-induced hypertension.
Literature
1.
Zhang J, Zeisler J, Hatch MC, Berkowitz G. Epidemiology of pregnancy-induced hypertension. Epidemiol Rev. 1997;19(2):218–32.PubMedCrossRef
2.
Xiong X, Fraser WD. Impact of pregnancy-induced hypertension on birthweight by gestational age. Paediatr Perinat Epidemiol. 2004;18(3):186–91.PubMedCrossRef
3.
Chen X-K, Wen SW, Smith G, Yang Q, Walker M. Pregnancy-induced hypertension and infant mortality: roles of birthweight centiles and gestational age. BJOG Int J Obstet Gynaecol. 2007;114(1):24–31.CrossRef
4.
5.
US National High Blood Pressure Education. program. Report of the national high blood pressure education program working group on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183(1):s1–s22.CrossRef
6.
North RA, McCowan LM, Dekker GA, Poston L, Chan EH, Stewart AW, et al. Clinical risk prediction for pre-eclampsia in nulliparous women: development of model in international prospective cohort. BMJ. 2011;342:d1875.PubMedPubMedCentralCrossRef
7.
Osungbade KO, Ige OK. Public health perspectives of preeclampsia in developing countries: implication for health system strengthening. J Pregnancy. 2011;2011:481095.PubMedPubMedCentralCrossRef
8.
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
9.
Mekbeb T, Ketsela K. Pre-eclampsia/eclampsia at Yekatit 12 hospital, Addis Ababa, Ethiopia (1987-1989). East Afr Med J. 1991;68(11):893–9.PubMed
10.
Vata PK, Chauhan NM, Nallathambi A, Hussein F. Assessment of prevalence of preeclampsia from Dilla region of Ethiopia. BMC Research Notes. 2015;8(1):816.PubMedPubMedCentralCrossRef
11.
Wolde Z, Segni H, Woldie M. hypertensive disorders of pregnancy in Jimma University Specialized Hospital. Ethiop J Health Sci. 2011;21(3):147–54.
12.
Teklu S, Gaym A. Prevalence and clinical correlates of the hypertensive disorders of pregnancy at Tikur Anbessa hospital, Addis Ababa, Ethiopia. Ethiop Med J. 2006;44(1):17–26.PubMed
13.
Shegaze M, Markos Y, Estifaons W, Taye I. Magnitude and Associated Factors of Preeclampsia Among Pregnant Women who Attend Antenatal Care Service in Public Health Institutions in Arba Minch Town, Southern Ethiopia, 2016. Gynecol Obstet. 2016;6(12):1–6.
14.
Godefay H, Byass P, Kinsman J, Mulugeta A. Understanding maternal mortality from top–down and bottom–up perspectives: Case of Tigray Region, Ethiopia. J Glob Health. 2015;5(1):1–8.
15.
Godefay H, Byass P, Graham WJ, Kinsman J, Mulugeta A. Risk Factors for Maternal Mortality in Rural Tigray, Northern Ethiopia: A Case-Control Study. PLoS One. 2015;10(12):e0144975.PubMedPubMedCentralCrossRef
16.
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.PubMedPubMedCentralCrossRef
17.
Kampruan R, Sukonpan K, Wasinghon P. Pregnancy outcomes amongst normotensive and severe preeclampsia with or without underlying chronic hypertension pregnancy. Thai J Obstet Gynaecol. 2016;24(3):202–8.
18.
Raghuraman N, March MI, Hacker MR, Modest AM, Wenger J, Narcisse R, et al. Adverse maternal and fetal outcomes and deaths related to preeclampsia and eclampsia in Haiti. Pregnancy Hypertens. 2014;4(4):279–86.PubMedCrossRef
19.
20.
Ngoc NTN, Merialdi M, Abdel-Aleem H, Carroli G, Purwar M, Zavaleta N, et al. Causes of stillbirths and early neonatal deaths: data from 7993 pregnancies in six developing countries. Bull World Health Organ. 2006;84(9):699–705.PubMedPubMedCentralCrossRef
21.
Kolluru V, Harika R, Kaul R. Maternal and perinatal outcome associated with pregnancy induced hypertension. Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3367–71.
22.
Liu C-M, Cheng P-J, Chang S-D. Maternal complications and perinatal outcomes associated with gestational hypertension and severe preeclampsia in Taiwanese women. J Formos Med Assoc. 2008;107(2):129–38.PubMedCrossRef
23.
Muti M, Tshimanga M, Notion GT, Bangure D, Chonzi P. Prevalence of pregnancy induced hypertension and pregnancy outcomes among women seeking maternity services in Harare, Zimbabwe. BMC Cardiovasc Disord. 2015;15:111.PubMedPubMedCentralCrossRef
24.
Kiondo P, Tumwesigye NM, Wandabwa J, Wamuyu-Maina G, Bimenya GS, Okong P. Adverse neonatal outcomes in women with pre-eclampsia in Mulago Hospital, Kampala, Uganda: a cross-sectional study. Pan Afr Med J. 2014;17(Suppl 1):1–5.
25.
Nathan HL, Seed PT, Hezelgrave NL, De Greeff A, Lawley E, Conti-Ramsden F, et al. Maternal and perinatal adverse outcomes in women with pre-eclampsia cared for at facility-level in South Africa: a prospective cohort study. J Glob Health. 2018;8(2):1–10.
26.
Melese MF, Badi MB, Aynalem GL. Perinatal outcomes of severe preeclampsia/eclampsia and associated factors among mothers admitted in Amhara region referral hospitals, North West Ethiopia, 2018. BMC Res Notes. 2019;12(1):147.PubMedPubMedCentralCrossRef
27.
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
28.
Chen XK, Wen SW, Smith G, Yang Q, Walker M. Pregnancy-induced hypertension is associated with lower infant mortality in preterm singletons. BJOG. 2006;113(5):544–51.PubMedCrossRef
29.
Ethiopia CSA, Macro ORC. Demographic and health survey 2016. Addis Ababa: Central Statistical Agency, Addis Ababa, Ethiopia; 2016.
30.
Fatemeh T, Marziyeh G, Nayereh G, Anahita G, Samira T. Maternal and perinatal outcome in nulliparious women complicated with pregnancy hypertension. J Pak Med Assoc. 2010;60(9):707.PubMed
31.
Hailemariam B. Pre-clampsia and its outcome (maternal and neonatal morbidity and mortality) in the two referral hospitals (Windhoek Central and Katutura), Namibia.
32.
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. 2015;5(1):12–16.
33.
Paknahad Z, Talebi N, Azadbakht L. Dietary determinants of pregnancy induced hypertension in Isfahan. J Res Med Sci. 2008;13(1):17–21.
34.
WHO. WHO STEPS surveillance manual: the WHO STEPwise approach to chronic disease risk factor surveillance. 2005.
35.
Endeshaw G, Berhan Y. Perinatal outcome in women with hypertensive disorders of pregnancy: a retrospective cohort study. Inter Sch Res Notices. 2015;2015:208043.
36.
Tessema GA, Tekeste A, Ayele TA. Preeclampsia and associated factors among pregnant women attending antenatal care in Dessie referral hospital, Northeast Ethiopia: a hospital-based study. BMC Pregnancy Childbirth. 2015;15(1):73.PubMedPubMedCentralCrossRef
37.
38.
WHO. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992.
39.
Brenner WE, Edelman DA, Hendricks CH. A standard of fetal growth for the United States of America. Am J Obstet Gynecol. 1976;126(5):555–64.PubMedCrossRef
40.
Adu-Bonsaffoh K, Ntumy MY, Obed SA, Seffah JD. Perinatal outcomes of hypertensive disorders in pregnancy at a tertiary hospital in Ghana. BMC Pregnancy Childbirth. 2017;17(1):388.PubMedPubMedCentralCrossRef
41.
Badal S, Singh LR. Maternal and perinatal outcome in severe pre-eclampsia and eclampsia. World J Pharm Med Res. 2017;3(3):193–5.
42.
Chaim SRP, Oliveira SMJV, Kimura AF. Pregnancy-induced hypertension and the neonatal outcome. Acta Paulista de Enfermagem. 2008;21(1):53–8.CrossRef
43.
Yucesoy G, Ozkan S, Bodur H, Tan T, Caliskan E, Vural B, 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.PubMedCrossRef
44.
Poonyane T. Impact of severe preeclampsia on maternal and fetal outcomes in preterm deliveries; 2015.
45.
Randriamahavonjy RTR, Andrianirina ZZ, Andrianampanalinarivo HR. Materno-fetal outcomes in pre eclampsia in a rural hospital of Antananarivo Madagascar. Int J Res Med Sci. 2018;6(4):1064–7.CrossRef
46.
Muchie KF. Quality of antenatal care services and completion of four or more antenatal care visits in Ethiopia: a finding based on a demographic and health survey. BMC Pregnancy Childbirth. 2017;17(1):300.PubMedPubMedCentralCrossRef
47.
48.
Mahran A, Fares H, Elkhateeb R, Ibrahim M, Bahaa H, Sanad A, et al. Risk factors and outcome of patients with eclampsia at a tertiary hospital in Egypt. BMC Pregnancy Childbirth. 2017;17(1):435.PubMedPubMedCentralCrossRef
49.
RT GTA. Prevalence of Pregnancy Induced Hypertension and Its Bad Birth Outcome among Women Attending Delivery Service. J Preg Child Health. 2017;4(335):1–4.
50.
Granger JP, Alexander BT, Bennett WA, Khalil RA. Pathophysiology of pregnancy-induced hypertension. Am J Hypertens. 2001;14(S3):178S–85S.PubMedCrossRef
51.
Gilbert JS, Ryan MJ, LaMarca BB, Sedeek M, Murphy SR, Granger JP. Pathophysiology of hypertension during preeclampsia: linking placental ischemia with endothelial dysfunction. Am J Phys Heart Circ Phys. 2008;294(2):H541–H50.
52.
George IO, Jeremiah I. Perinatal outcome of babies delivered to eclamptic mothers: a prospective study from a Nigerian tertiary hospital. Int J Biomed Sci. 2009;5(4):390.PubMedPubMedCentral
53.
Randriamahavonjy R, Tsifiregna RL, Andrianirina ZZ, Andrianampanalinarivo HR. Materno-fetal outcomes in pre eclampsia in a rural hospital of Antananarivo Madagascar. Int J Res Med Sci. 2018;6(4):1064–7.CrossRef
54.
Kumar S, Kumar N, Vivekadhish S. Millennium development goals (MDGs) to sustainable development goals (SDGs): addressing unfinished agenda and strengthening sustainable development and partnership. Indian J Community Med. 2016;41(1):1–4.PubMedPubMedCentralCrossRef
55.
Health FMo. Health Sector Transformation Plan (2015/16-2019/20). Ethiopia: Federal Ministry of Health Addis Ababa; 2015.
56.
Ebeigbe P, Aziken ME. Early onset pregnancy induced hypertension/eclampsia in Benin City, Nigeria. Niger J Clin Pract. 2010;13(4):388–93.
57.
Onah H, Iloabachie G. Conservative management of early-onset pre-eclampsia and fetomaternal outcome in Nigerians. J Obstet Gynaecol. 2002;22(4):357–62.PubMedCrossRef
58.
Health FMo. Basic Emergency Obstetric & Newborn Care (BEmONC) training manual. 2014.
Metadata
Title
Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study
Authors
Abadi Kidanemariam Berhe
Abiodun O. Ilesanmi
Christopher O. Aimakhu
Afework Mulugeta
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2708-6

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