J L Browne1, K M Vissers1,2, E Antwi1,3, E K Srofenyoh4, E L Van der Linden1, I A Agyepong5, D E Grobbee1, K Klipstein-Grobusch1,6. 1. Julius Global Health, Julius Centrum for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 2. Gelderse Vallei Hospital, Ede, The Netherlands. 3. Ghana Health Service, Accra, Ghana. 4. Ridge Regional Hospital, Ghana Health Service, Accra, Ghana. 5. Department of Health Policy, Planning and Management, University of Ghana, Accra, Ghana. 6. Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Abstract
OBJECTIVE: The objective of this study was to evaluate perinatal outcomes of pregnancies complicated by hypertensive disorders in pregnancy in an urban sub-Saharan African setting. METHODS: A prospective cohort study of 1010 women of less than 17 weeks of gestation was conducted at two antenatal clinics in Accra, Ghana, between July 2012 and March 2014. Information about hypertensive disorders was available for analysis on 789 pregnancies. The main outcomes were pre-term birth, birthweight, Apgar scores, small for gestational age and mortality. Relative risk (RR, 95% confidence interval (CI)) for the association between hypertensive disorders of pregnancy and perinatal outcomes was assessed using logistic regression adjusting for potential confounders. RESULTS: A total of 88.7% of women remained normotensive, 7.5% developed pregnancy-induced hypertension, 2.0% had chronic hypertension, and 1.7% developed (pre-)eclampsia. No adverse effects were observed in women with pregnancy-induced hypertension. Women with chronic hypertension were more likely to have a lower gestational age at delivery (38.0 ± 2.3 weeks vs. 39.0 ± 1.9 weeks, P = 0.04) and higher risk of pre-term delivery (aRR 4.63, 95% CI 1.35-15.91). Women with pre-eclampsia had emergency Caesarean section significantly more often (88.9% vs. 50%, P = 0.04), with a higher risk for low birthweight infants (aRR 7.95, 95% CI 1.41-44.80) and a higher risk of neonatal death (aRR 18.41, 95% CI 1.20-283.22). CONCLUSION: Comparable to high-income countries, in Accra hypertensive disorders during pregnancy were associated with increased risk of adverse perinatal outcomes necessitating maternal and newborn care.
OBJECTIVE: The objective of this study was to evaluate perinatal outcomes of pregnancies complicated by hypertensive disorders in pregnancy in an urban sub-Saharan African setting. METHODS: A prospective cohort study of 1010 women of less than 17 weeks of gestation was conducted at two antenatal clinics in Accra, Ghana, between July 2012 and March 2014. Information about hypertensive disorders was available for analysis on 789 pregnancies. The main outcomes were pre-term birth, birthweight, Apgar scores, small for gestational age and mortality. Relative risk (RR, 95% confidence interval (CI)) for the association between hypertensive disorders of pregnancy and perinatal outcomes was assessed using logistic regression adjusting for potential confounders. RESULTS: A total of 88.7% of women remained normotensive, 7.5% developed pregnancy-induced hypertension, 2.0% had chronic hypertension, and 1.7% developed (pre-)eclampsia. No adverse effects were observed in women with pregnancy-induced hypertension. Women with chronic hypertension were more likely to have a lower gestational age at delivery (38.0 ± 2.3 weeks vs. 39.0 ± 1.9 weeks, P = 0.04) and higher risk of pre-term delivery (aRR 4.63, 95% CI 1.35-15.91). Women with pre-eclampsia had emergency Caesarean section significantly more often (88.9% vs. 50%, P = 0.04), with a higher risk for low birthweight infants (aRR 7.95, 95% CI 1.41-44.80) and a higher risk of neonatal death (aRR 18.41, 95% CI 1.20-283.22). CONCLUSION: Comparable to high-income countries, in Accra hypertensive disorders during pregnancy were associated with increased risk of adverse perinatal outcomes necessitating maternal and newborn care.
Authors: Maria Barreix; Kelli Barbour; Affette McCaw-Binns; Doris Chou; Max Petzold; Gathari N Gichuhi; Luis Gadama; Frank Taulo; Özge Tunçalp; Lale Say Journal: Int J Gynaecol Obstet Date: 2018-05 Impact factor: 3.561
Authors: Ibrahim A Abdelazim; Yerbol Bekmukhambetov; Raisa Aringazina; Svetlana Shikanova; Osama O Amer; Gulmira Zhurabekova; Makhmutsultangali A Otessin; Akezhan R Astrakhanov Journal: J Family Med Prim Care Date: 2020-03-26
Authors: Aruna M Kamath; Casey K Johanns; Maximillian G Thom; Rebecca M Cogen; Diego Rios-Zertuche; Ali H Mokdad; Bernardo Hernández Journal: Int J Gynaecol Obstet Date: 2020-03-25 Impact factor: 3.561