Prospective cohort study of persistent hypertension following pre-eclampsia at Medani Hospital, Sudan

Fadalallah, Zubaida Moftah El Kheir; Elhassan, Elhassan M.; Rayis, Duria A.; Abdullahi, Hala; Adam, Ishag

doi:10.1016/j.ijgo.2015.11.014

Cited by 8 publications

(10 citation statements)

References 19 publications

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“…This study observed high rates of persistent hypertension regardless of HDP subtype (21% and 61% of women with gestational hypertension and pre-eclampsia, respectively). This is in line with findings from other studies within sub-Sahara Africa in Nigeria, Cameroon, Uganda and Sudan [ 10 11 12 13 14 ], which reported rates between 25.5% and 35.6% six weeks to six months after delivery of HDPs-complicated pregnancies.…”

Section: Discussionsupporting

confidence: 92%

“…This retention rate was also commendable based on recommended follow up rates between 50 – 80% for cohort studies [ 15 16 17 ]. To our knowledge, this is the largest cohort of women with HDPs followed up the longest in African settings (previous single-center studies in Cameroon, Nigeria, Sudan and Ugandan were for between six weeks to six months) [ 10 11 12 13 14 ]. This study enrolled women from eight tertiary health facilities spread across Nigeria ensuring diversity of patients and settings.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, estimation and quantification of the true magnitude of persistent hypertension in HDPs is an important initial step to curb the risk of future chronic hypertension and adverse cardiovascular events [ 7 8 ], for which sub-Saharan Africa suffers disproportionately [ 9 ]. Despite these facts, few studies have been conducted in low-resource settings and mostly restricted to short postpartum follow up [ 10 11 12 13 14 ]. This study prospectively determined the prevalence of hypertension over one year in a cohort of Nigeria’s women with HDPs who delivered in tertiary facilities and assessed the risk factors associated with persistent hypertension.…”

Section: Introductionmentioning

confidence: 99%

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Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study

Ishaku

Tukur

Innocent

et al. 2021

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Background: Hypertensive disorders in pregnancy (HDPs) are associated with lifelong cardiovascular disease risk. Persistent postpartum hypertension in HDPs could suggest progression to chronic hypertension. This phenomenon has not been well examined in low-and middle-income countries (LIMCs), and most previous follow-ups typically last for maximally six weeks postpartum. We assessed the prevalence of persistent hypertension up to one year in women with HDPs in a low resource setting and determined associated risk factors. Methodology: A prospective cohort study of women conducted at eight tertiary health care facilities in seven states of Nigeria. Four hundred and ten women with any HDP were enrolled within 24 hours of delivery and followed up at intervals until one year postpartum. Descriptive statistics were performed to express the participants' characteristics. Univariable and multivariable logistic regressions were conducted to identify associated risk factors. Results: Of the 410 women enrolled, 278 were followed up to one year after delivery (follow-up rate 68%). Among women diagnosed with gestational hypertension and pre-eclampsia/ eclampsia, 22.3% (95% CI; 8.3-36.3) and 62.1% (95% CI; 52.5-71.9), respectively, had persistent hypertension at six months and this remained similar at one year 22.3% (95% CI; 5.6-54.4) and 61.2% (95% CI; 40.6-77.8). Maternal age and body mass index were significant risk factors for persistent hypertension at one year [aORs = 1.07/year (95% CI; 1.02-1.13) and 1.06/kg/m 2 (95% CI; 1.01-1.10)], respectively. Conclusion: This study showed a substantial prevalence of persistent hypertension beyond puerperium. Health systems in LMICs need to be organized to anticipate and maintain postpartum monitoring until blood pressure is normalized, or women referred or discharged to family physicians as appropriate. In particular, attention should be given to women who are obese, and or of higher maternal age.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study

Ishaku

Tukur

Innocent

et al. 2021

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“…In the current study, none of the biochemical (creatinine /uric acid/aspartate aminotransferase/alanine aminotransferase levels) or demographic (age, pregnancy duration, parity, and BMI) variables studied showed an association with persistent hypertension post preeclampsia. A study by Fadalallah et al [17] in Sudan demonstrated similar findings of non-association. This appears differently in relation to past studies that showed various predictive variables (age, pregnancy duration, age, creatinine, and severe preeclampsia/early onset preeclampsia) for the persistent hypertension post-preeclampsia [12][13][14][15].…”

Section: Discussionsupporting

confidence: 53%

Persistent hypertension post-preeclampsia: a tertiary care centre-based study in China

Ma¹,

Yao²

2018

Clin. Exp. Obstet. Gynecol.

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To determine the predictors of persistent hypertension post-preeclampsia in a single center in Chinese patients. Materials and Methods: Clinical/demographic, obstetric, and biochemical data were collected during presentation and at six weeks' follow up period post-delivery from women with preeclampsia between October 2014 to September 2015. Results: Out of 198 patients enlisted, follow up (six weeks) data was accessible for 173 patients, out of which 143 (82.7%) and 30 (17.3%) patients had mild and severe preeclampsia, respectively. At the time of followup (six weeks), persistent hypertension was recorded in 61 (35.3%) patients. There was no significant association/difference noted for age, BMI, parity, and pregnancy duration in persistent hypertension group vs. normotensive group. Significantly low platelets count (p = 0.001) and low birth weights (p < 0.001) were noted in the persistent hypertension group. Patients encountering persistent hypertension at followup (six weeks) were observed to be mostly having severe preeclampsia earlier in contrast to normotensive group (p < 0.001). There was no association of variables with persistent hypertension; although, patients having severe preeclampsia were previously found to encounter persistent hypertension 7.1 times more compared to patients having mild/moderate preeclampsia (95% CI [confidence interval] 1.4-31.4; p = 0.007). Conclusion: Persistent hypertension was noted to be extremely frequent post six weeks of delivery in preeclampsia patients (particularly severe preeclampsia) in China, irrespective of parity as well as age.

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“…Preeclampsia/eclampsia is the leading cause of obstetric complications and maternal mortality in Sudan [15–18]. The current study was conducted at Omdurman Maternity Hospital, Sudan to determine the level of AMH in women with preeclampsia and to add on our recent research on preeclampsia in Sudan [19–21]. …”

Section: Introductionmentioning

confidence: 99%

Maternal serum anti-Müllerian hormone in Sudanese women with preeclampsia

et al. 2017

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ObjectivesA case–control study was conducted at Omdurman Maternity Tertiary Hospital, Sudan, during the period from May to August 2014 to investigate AMH level in women with preeclampsia compared to healthy controls. The cases were women with preeclampsia and healthy pregnant women were the controls. The obstetrics and medical history was gathered using a questionnaire. AMH level was measured using ELISA.ResultsThere was no significant difference between the two groups (40 in each arm of the study) in the age, parity and gestational age. Thirty-three of the 40 cases were patients with severe preeclampsia. There was no significant difference in median inter-quartile of the AMH level between the women with preeclampsia and the controls [0.700 (0.225–1.500) vs. 0.700 (0.400–1.275) ng/ml, P = 0.967]. In a linear regression model there was no association between the log of AMH and age, parity, gestational age, BMI, hemoglobin level and preeclampsia.

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Prospective cohort study of persistent hypertension following pre-eclampsia at Medani Hospital, Sudan

Abstract: Persistent hypertension 6weeks after delivery was common among patients who experienced pre-eclampsia in Sudan (particularly severe pre-eclampsia) regardless of patients' age and parity.

Cited by 8 publications

References 19 publications

Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study

Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study

Persistent hypertension post-preeclampsia: a tertiary care centre-based study in China

Maternal serum anti-Müllerian hormone in Sudanese women with preeclampsia

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