Perinatal outcomes of hypertensive disorders in pregnancy at a referral hospital, Southern Ethiopia

Abstract

Introduction Hypertensive Disorders in Pregnancy (HDP) complicate about 10% of pregnancies. It accounts to 50% of maternal death in sub-Saharan Africa and precedes 15% of perinatal deaths worldwide. In this study, we looked at the perinatal outcomes and factors associated with unfavorable perinatal outcomes among women with hypertensive disorders in pregnancy at Wolaita Sodo teaching and referral hospital, southern Ethiopia. Methods A hospital based retrospective cross-sectional study design was employed among women hospitalized for hypertensive disorders in pregnancy. Socio-demographic, obstetrics, clinical laboratory, pregnancy complications and outcome were checked from patient records. Descriptive statistics were used to describe parameters collected from patient records. Bivariate and multiple logistic regressions were done to determine factors associated with unfavorable perinatal outcome. A P-value of less than 0.05 and 95% confidence interval not including 1 were considered statically significant. Results There were 168 (2.3%) cases of HDP of the total 7, 347 deliveries during the period of the study from January 2014-December 2016. 72.5% of mothers (72.5%) had vaginal delivery and 26.1% had Caesarean Section. This study revealed a perinatal mortality rate of 111.1 per 1000 live births. On bivariate logistic regression variables such as referral status, diastolic blood pressure, ANC use, types of HDP, fetal weight at birth, maternal complication and maternal outcome were found to be associated with unfavorable perinatal outcomes. On multiple logistic regression fetal weight at birth and maternal outcome were found to be an independent predictors of unfavorable perinatal outcome. Conclusion Our study shows higher perinatal mortality in a tertiary hospital where emergency obstetric and newborn care is set and quality obstetric care is expected. However, tertiary facilities manage difficult cases which can explain the high PMR. But it is high which means there is enough room for improvement. Hence, the referral hospital and neighboring health facilities should give due emphasis for early detection and management of women with HDP.

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

“…In this study, approximately one-third (28.8%) of the newborns delivered from women with PIH were admitted to the neonatal intensive care unit (NICU). This finding was consistent with the study conducted in Uganda (32.1%) and Ghana (24.7%) (21,47) but higher than a study conducted in Iran (13%) (31). The higher risk of newborn baby admission to NICU might be related to the effect of PIH on low birth weight, birth asphyxia, and preterm births.…”

Risks of adverse perinatal and maternal outcomes among women with hypertensive disorders of pregnancy in southwestern Uganda

“…To date, most studies examining maternal and perinatal outcomes in women with HDP from sub-Saharan Africa have been limited to retrospective and cross-sectional data [7][8][9][10][11][12][13][14][15][16][17]. Additionally most studies from sub-Saharan Africa are from institutions based in large urban and metropolitan areas, thus data is lacking on outcomes among women with HDP seeking care in more rural and agrarian settings [9,12,15,18].…”

“…Existing data suggest an increased risk of maternal and perinatal adverse outcomes in women with HDP compared to women without HDP [15,17,19,20]. Several demographic (age, education, rural domicile), medical (pre-existing hypertension, multiparity, gestational age at delivery) and management (timing of drug administration) characteristics have been identified as risk factors for adverse perinatal and maternal outcomes among women with HDP [9- 11,14,15,[21][22][23]. However, it is unknown if similar rates of adverse outcomes and risk factors persist in a mostly rural population.…”

The impact of pregnancy induced hypertension on low birth weight in Ethiopia: systematic review and meta-analysis

“…In Ethiopia, several individual studies were done and reported inconsistent findings in the relationship between PIH and LBW, except one review published in 2019 which didn't include all currently available researches on association of PIH and LBW (studies done after the previous review) [30]. Accordingly, the prevalence of LBW among PIH women ranges from 9.8% [31] to 64.4% [32]. In addition, the odds of developing LBW among women who had PIH range from 1.31 to 10.33 [20,33].…”