Maternal and fetal outcome of hypertension related pregnancy and their associated risk factors in Adigrat General Hospital, Northern Ethiopia, hospital based retrospective cohort study
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Date
2020-03-01
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Kamuzu University of Health Sciences
Abstract
This was a quantitative retrospective cohort study and Presence of hypertensive (exposure) was assessed retrospectively from medical records of mothers who visited the obstetric ward in Adigrat General Hospital, Tigray regional state, northern Ethiopia from January 1 2017- December 30 2019. Hypertensive disorders of pregnancy are the most common causes of adverse maternal & perinatal outcomes. Conducting such studies would support to have great design policies and strategies in preventing unfavorable outcome. The General objective of this study was to determine maternal and fetal outcome and risk factors associated with pregnancy related hypertensive disorder who receive obstetric care in Adigrat General Hospital, Eastern Tigray, and Northern Ethiopia from January 2017 to December 2019.
The data were collected using data extraction sheet and entered in to Epi info and analyzed in SPSS version 25. Strength of association was measured using odds ratio and 95% confidence intervals. The p-value <0.05 was set for statistical significance. I have found huge burden of maternal and perinatal death and complications, which makes it a big priority for the health system. A total 314 records of pregnant women was included in the study, 164 had developed HDP, but due to incompleteness and twin gestation, 14 records of those with HDP were excluded from the analysis, this resulted in the HDP prevalence of 50% (150/300). The dominant type of HDP in pregnant women studied was Preeclampsia. Majority of the study participants (90.33%) tested negative for HIV and more than ninety percent of the participants (94.67%) had Anti natal follow up. Majority of pregnant women (62.67%) underwent Spontaneous Vaginal Delivery (SVD) of which (38.7%) had HDP. Prevalence of chronic medical illness in participants was as follows, Proteinuria (72.0 %), DM (22%), CHD
(3.33%), Renal failure (2.7%). The proportion of the type of HDP chronic hypertension in pregnant women (preeclampsia, Eclampsia, super imposed preeclampsia, and gestational hypertension) were 42.00%, 25.3%, 7.30%, 12.0% and 13.30% respectively. The most frequent type of antihypertensive drug given to the mothers with HDP was hydralazine (87.3%) and mgso4 (59.3%). On a logistic regression analysis, several factors were found to be associated with HDP, these included age (OR 0.15; 95% CI, 0.09-0.25, P≤0.001), education (OR 0.43; 95% CI, 0.32-0.58; P≤0.01), occupation (OR 0.65; 95% CI, 0.51-0.84; P≤0.001), residency (OR 14.24; 95% CI, 7.95-25.53; P≤0.001), HIV status (OR 16.24; 95% CI, 3.78-69.69; P≤0.001), parity (OR 0.19; 95% CI, 0.99-0.39; P≤0.001), mode of delivery (OR 3.87; 955 CI, 2.59-5.78; P≤0.001) and diabetes mellitus (OR 17.37; 95% CI, 7.22-41.84; P≤0.001).
Out of the total 6,856 deliveries, 164 (2.4%) had HDP of which 14 were excluded. out of the 150 study participants with HDP majority of them 93 (62%) were in the age range of 15-35 years. More than half of respondents with HDP (68.7%) place of residence is in rural.