Predictors, prevalence and outcome of hypertensive disorders in pregnancy in Nigerian tertiary health facilities

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL

ACS Applied Energy Materials Pub Date : 2024-07-03 DOI:10.1111/1471-0528.17902

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

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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.

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尼日利亚三级医疗机构妊娠期高血压疾病的预测因素、发病率和结果：质量、公平和尊严计划孕产妇和围产期数据库的二次分析。

目的：确定妊娠期高血压疾病（HDP）的发病率、风险因素和预后：确定妊娠期高血压疾病（HDP）的患病率、风险因素和结果：对产妇和围产期质量、公平和尊严数据库（MPD-4-QED）在 2019 年 9 月至 2020 年 8 月期间采集的数据进行横断面分析：尼日利亚 54 家转诊机构：方法：描述性统计和多层次分析：描述性统计和多层次混合效应逻辑回归模型：主要结果测量指标：HDP 的患病率、与 HDP 相关的社会人口学和临床因素以及围产期结局：71 758 名妇女中有 6.4% 患有 HDP，49.8% 患有妊娠高血压。子痫前期和子痫分别占所有孕妇的 9.5%和 7.0%。妊娠高血压的预测因素是年龄超过 35 岁（OR1.96，95% CI 1.82-2.12；P 结论：妊娠高血压是一种常见的妊娠并发症：妊娠期高血压疾病在尼日利亚并不少见。它们与不良后果有关，超过四分之一的子痫妇女会死亡。主要的预测因素包括高龄、受教育程度低、胎次过多以及曾发生过分娩或流产。产妇和围产期的结果很差，约四分之一的产妇会出现并发症，约十分之一的产妇会死产。

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.