Prevalence of hypertensive disorders of pregnancy in Ethiopia: a systemic review and meta-analysis

Abstract

BackgroundAlthough hypertensive disorders of pregnancy are the leading cause of poor perinatal outcomes in Ethiopia, there is no study that shows the national prevalence. Therefore, the aim of this study was to estimate the national pooled prevalence of hypertensive disorders of pregnancy from studies conducted in different parts of the country.MethodsDatabases; MEDLINE, PubMed, HINARI, EMBASE, Google Scholar and African Journals Online were searched by using different search terms on HDP and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal of studies. The analysis was done using STATA 14 software. The Cochran Q test and I2 test statistics were used to test heterogeneity of studies. Egger’s test was used to show the publication bias. The pooled prevalence of HDP and the odds ratio (OR) with 95% confidence interval was presented using forest plots.ResultSeventeen studies were included in this review, with a total of 258,602 pregnant women. The overall pooled prevalence of hypertensive disorders of pregnancy in Ethiopia was 6.07% (95% CI: 4.83%, 7.31%). The Subgroup analysis by region and year of study showed a higher prevalence of hypertensive disorders of pregnancy in Southern Nations, Nationalities, and Peoples’ Region, 10.13% (95% CI = (8.5, 12.43)), and reduction in the rate of HDP from 1990’s to 2010’s, 8.54% reducing to 5.71% respectively. The pooled prevalence of pregnancy-induced hypertension (PIH) and preeclampsia/eclampsia alone were 6.29 and 5.47 respectively. Pregnant women ≥ 35 years old are more likely to develop hypertensive disorders of pregnancy, OR = 1.64 (95% CI = (1.18, 2.28)). No statistically significant difference was observed between HDP and younger maternal age (less than 20 years old); OR = 2.92 (95% CI = (0.88, 9.70)). There was no association between hypertensive disorders of pregnancy and number of pregnancy, OR = 1.37 (95% CI = 0.78, 2.41)).ConclusionsThe prevalence of hypertensive disorders of pregnancy is high in Ethiopia. The problem is more common among older pregnant women (> 35 years old). Government and other stakeholders should give due attention to an early screening of hypertension during pregnancy.

Maternal and perinatal outcome in eclampsia at a tertiary care center

“…22 SBP of 140mmHg or more and DBP of 90 mmHg or more is considered as cut-off level. 11 In our study 14% patients had normal BP recording at presentation. Mattar F et al, quoted 16% of the patients had no hypertension.…”

“…7,8 The frequency is significantly lower in developed countries and may be credited to effective antenatal services. 7,[9][10][11] Prominent rates of eclampsia at our setting may be related to high referrals received from urban health centers, primary health centers, rural hospitals, sub district hospitals and also from private hospitals.…”

“…1 Wide difference in incidence of eclampsia has been observed between developing and developed countries. 2 Majority of cases of eclampsia are young primigravidas and unregistered. Preeclampsia can rapidly progress to eclampsia, especially if untreated.…”

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

“…Besides, a study conducted on hypertension during pregnancy in Ethiopia recommended further study on the adverse outcomes of PIH (25). In addition, according to the finding of a study conducted in Tigray regional state, PIH was among the leading obstetric causes of maternal mortality in the region and the prevalence of PIH reported in this study was 8.1%, this was higher than the national pooled prevalence of PIH (6.29%) (26)(27)(28). However, so far little is known about the incidence and risk of adverse perinatal outcomes of PIH in Tigray regional state.…”

Health service utilisation lags behind maternal diseases or illnesses during pregnancy in rural south Ethiopia: A prospective cohort study

“…Although iron-folic-acid supplementation is recommended for prevention or treatment of anaemia to all pregnant and women who gave birth [18], there is limited data about the uptake of iron-folic-acid supplementation during the postpartum period from Ethiopia [17]. Hypertension is also common during pregnancy, and 10 % of pregnant women globally [19], and 6% in Ethiopia had hypertension [20]. Hypertension is a well-known risk factor for maternal death, preeclampsia/ eclampsia, and cardiac and renal complications during pregnancy and the postpartum period [21].…”