Antenatal care and its effect on risk of pregnancy induced hypertension in Lao PDR: A case-control study

Abstract

Background: Pregnancy induced hypertension (PIH) is a global public health concern as a leading cause of maternal mortality. Lao PDR has a high prevalence of PIH, but little is known about its risk factors. This study aimed to identify risk factors of PIH relating to antenatal care (ANC) in Lao PDR. Methods: This hospital-based age-matched case control study was carried out between July and December 2017 in tertiary and secondary hospitals in Lao PDR. A total of 258 pregnant women (86 hypertensive and 172 normotensive pregnant women) were recruited to join the study based specific inclusion criteria. For each case, two consecutive controls were included in the study with matched maternal age. Data was collected using a structured questionnaire interview to identify the risk factors of PIH relating to ANC. The association between the independent variables and PIH was assessed through bivariable and conditional multiple logistic regression analyses. Results: Mothers with PIH had inadequate ANC (defined as <4 times) (adj. OR= 10.23 , 95%CI: 3.67 – 28.49, p<0.001), excessive maternal weight gain during pregnancy (>13kg) ( adj. OR=7.35, 95%CI: 3.06 -17.69, p<0.001), had a history of abortion (adj. OR=3.54, 95%CI: 1.30-9.59, p=0.013), and had received inadequate information about PIH (adj OR= 2.58 , 95%CI: 1.03 – 6.46 , p=0.043). Conclusion: Inadequate ANC and maternal factors were major risk factors of PIH in Lao PR. National PIH guidelines for effective counseling, ANC and treatment should be promptly developed and implemented at all levels in order to improve pregnancy outcomes.

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“…They reported that the majority of antenatal PIH women were primigravida, had a gestation period of 28 weeks, and had no history of multiple pregnancy or past history of medical disorders [22]. Also, these results were in line with those of Ronsmans and Campbell (2017), reporting that health care personnel were evaluated on their understanding and management methods of hypertension in pregnancy [23]. The majority of sample were primigravida and in second trimester.…”

“…The majority of sample were primigravida and in second trimester. On other hand, these results were dissimilar to those of Phengsavanh et al (2018) research on the effect of antenatal care on risk of pregnancy induced hypertension in lao PDR [24]. Also, these results were different from those of Ramesh et al (2014), based on which the majority of the women had a history of hypertension and diabetes [25].…”

Examining the Effect of Education on Dietary Calcium Intake in Reducing Blood Pressure Variability Among Pregnant Mothers in Tigray Region, Northern Ethiopia, Two Arm, Randomized Control Trail Parallel Design

“…With adequate ANC (≥ 4 times), pregnant women would be monitored and have better pregnancy outcomes and a reduction in complications. This study is supported by study done in Thailand[17], USA[18]. Pregnancy induced hypertension is not a totally preventable disease but maternal and foetal Complication due to PIH can be halted at mild stage by quality Antenatal care with good outcome through controlling blood pressure variability.The other main exposure variable used in our study was self-reported consumption of iron and folic acid supplementation during pregnancy.…”

Underutilization of the recommended frequency of focused antenatal care services in Northwest Ethiopia: Using Andersen's healthcare service utilization model approach

“…12,13 Women with irregular antenatal care attendance are much more prone to pregnancy complications such as preeclampsia, eclampsia, and anemia besides higher adverse birth outcomes including preterm birth, low birth weight, and stillbirth. [14][15][16] The magnitude of PPH (postpartum hemorrhage), preterm labor, early neonatal death, and LBW (Low Birth Weight) complication reduced when a woman has complete adherence to ANC visit. 17 Kinds of the literatures showed that no maternal education, 11,18-23 permission to visit health facility, 18,21 less maternal exposure to the media, 20,21 long distance to health facilities, 20,22 and lack of companionship to health facility 21 were some of the factors repeatedly associated with underutilization of the recommended visits of FANC.…”