DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20170255
Published: 2017-01-25

Incidence of gestational hypertension among pregnant women (2006-2015) in Enugu State, Southeast Nigeria: a retrospective study

Emmanuel I. Umegbolu, John O. Ogamba

Abstract


Background: Gestational hypertension (GHTN) is defined as a new rise in blood pressure (BP) ≥140/90 mm Hg, presenting at 20 weeks gestation without significant proteinuria. Worldwide, 4.4%-15% of all pregnancies are complicated by HTN. The aim of this study was to determine the incidence of GHTN among pregnant women in Enugu State, Southeast Nigeria with a view to improving and strengthening antenatal services in the State to help reduce the proportion of maternal mortality and fetal outcomes attributable to GHTN and reduce the overall prevalence of HTN in the country.

Methods:Records of BP, biodata and laboratory investigations (urinalysis, full blood count) of women who attended antenatal clinics in six selected state hospitals (2006-2015) were examined. Data were analyzed as proportions, t-test, ANOVA and Pearson product moment correlations using Maxstat (version 3.60) statistical software.

Results: The overall incidence of GHTN was 5.9% with annual fluctuations with peaks in 2010 and 2014. There were significant differences in incidence among the age groups (<20 years, 20-35 years and >35 years) (p<0.0001) and between nulliparous and multiparous women (p=0.0016). There was positive, strong and significant correlation between age (20-35 years and >35 years) and GHTN (r=0.932, p=0.0069). Between parity and GHTN, there was also positive, strong and significant correlation (r=0.813, p=0.0491).

Conclusions:With an incidence of GHTN at 5.9%, there is need to improve and sustain adequate antenatal services in order to help reduce the proportion of the country’s maternal mortality attributable to hypertensive disorders of pregnancy.


Keywords


Blood pressure, Gestational, Hypertension, Multiparous, Nulliparous

Full Text:

PDF

References


New York State Department of Health. Hypertensive disorders in pregnancy: guideline summary, 2013. Available at https://www.health.ny.gov/.../hypertensive_disorders/2013_hdp_guideline_... Accessed 12 July 2016.

Krishnachetty B, Plaat F. Management of hypertensive disorders of pregnancy. Anaest Tut Week. 2014;304:1-13.

Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obst & Gyn. 2003;102(1):181-92.

Parmar MT, Solanki HM, Gosalia VV. Study of risk factors of perinatal death in pregnancy induced hypertension (PIH). Nat J Com Med. 2012;3(4):703-7.

Chandiramani M, Shennan A, Waugh J. Medical problems in pregnancy: Modern management of postpartum hypertension. Trends Urol, Gyn & Sexual Health. 2007:37-40.

Kintiraki E, Papakatsika S, Kotronis G, Goulis DG, Kotsis V. Pregnancy-induced hypertension. Hormones. 2015;14(2):211-23.

Bansode BR. Managing Hypertension in Pregnancy. Med Update. 2012;22:150-6.

King Edward Memorial hospital Australia. Complications of pregnancy: hypertension in pregnancy, 2016. Available at http://www.kemh.health.wa.gov.au/development/manuals/O&G.../5146.pdf

Brown MA, Hague WM, Higgins J. The detection, investigation and management of hypertension in pregnancy: full consensus statement. Aust N Z J Obstet Gynecol. 2000:139-55.

National High Blood Pressure Education Program Working group. Report of the National High Blood Pressure Education Program working group on High Blood Pressure in pregnancy. Am J Obstet Gynecol. 2000;183:1-22.

Sajith M, Nimbargi V, Modi A, Sumariya R, Pawar A. Incidence of pregnancy induced hypertension and prescription pattern of antihypertensive drugs in pregnancy. Int J Pharm S Res (IJPSR). 2014;5(04):163-170.

Ajana S, Poonam M, Shradha B. Management of pregnancy induced hypertension. Int J Res Ayurv Pharm. 2010;1(2):390-8.

James RP, Nelson-Piercy C. Management of hypertension before, during, and after pregnancy. Heart. 2004;90:1499-1504.

Wagner LK. Diagnosis and Management of Preeclampsia. Am Fam Phys. 2004;70(12):2317-24

Khosravi S, Dabiran S, Lotfi M, Asnavandy M. Study of the prevalence of hypertension and complications of hypertensive disorders in pregnancy. Open J Prev Med. 2014;4:860-7.

Kumari P, Sharma SN, Kumar S, Kumar M. A Comparative study of blood pressure in normal and pregnancy induced hypertensive cases for early diagnosis of hypertensive disorders in a tertiary care hospital. Int J Sc Study. 2014;2(3):33-7.

Browne JL, Vissers KM, Antwi E, Srofenyoh EK, Van der Linden EL, Agyepong IA, Grobbee DE, Klipstein-Grobusch K. Perinatal outcomes after hypertensive disorders in pregnancy in a low resource setting. Trop Med Int Health. 2015;20(12):1778-86.

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 Card Dis. 2015;15:1-8.

Nwabueze OP, Abanobi CO, Nwankwo BO, Nwabueze AE. Occurrence of pregnancy induced hypertension in selected health facilities in Southeast Nigeria. Int Trop Med. 2012;7(2):86-92.

Igbokwe CC, Ukwuma MC. Incidence of hypertension among pregnant women in Enugu East Local Government Area of Enugu State. Int J Res Arts Soc Sc. 2013;6:303-15.

Singh S, Ahmed EB, Egondu SC, Ikechukwu NE. Hypertensive disorders in pregnancy among women in a Nigerian Teaching Hospital. Nig Med J. 2014;55(5):384-8.

Ebeigbe PN, Igberase GO, Aziken ME. Hypertensive disorders in pregnancy: experience with 442 recent consecutive cases in Benin City, Nigeria. Nig Med J. 2007;48(4):94-8.

WHO, UNICEF, World Bank Group, UNPD. Trends in maternal mortality: 1990-2015, 2016. Available at www.who.int/reproductivehealth/ publications/.../maternal-mortality.../en/ . Accessed 30 September 2016

Say L, Chon D, Gemmill A, Turicalp O, Moller A-B, Daniels J, Chlmezogin M, Temmerman M, Akema L. Global causes of maternal death: a WHO systematic analysis. The Lancet G Health. 2014;06.

Adeloye D, Basquill C, Aderemi AV, Thompson JY, Obi FA. An estimate of the prevalence of hypertension in Nigeria: A systematic review and meta-analysis. J Hyp. 2015;33:230-42.

Mammaro A, Carrara S, Cavaliere A, Ermito S, Dinatale A, Pappalardo EM, Militello M, Pedata R. Hypertensive disorders in pregnancy. J Pren Med. 2009;3(1):1-5.

Anderson NR, Undeberg M, Bastianelli KMS. Pregnancy-induced hypertension and preeclampsia: a review of current antihypertensive pharmacologic treatment options. Aust J Pharm Ther. 2013;1(1):1-8.

Shah MR. Hypertensive disorders in pregnancy (1 st ed). : Jaypee; 2007:1-10.

Rehman MO, Din SU, Siddiqui MA, Rehman S. Incidence of women having pregnancy induced hypertension in Karachi. Pak. J Pharmacology. 2003;20(1):5-8.

Anderson GH. Effect of age on hypertension: analysis of over 4 800 referred hypertensive patients. Saudi J Kidney Dis Transplant. 1999;10(3):279-86.

Carson MP, Ramus RM. Hypertension and Pregnancy: overview, chronic hypertension, differential diagnosis, 2016. Available at http://emedicine. medscape.com/article/261435-overview.