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

Berhe, Abadi Kidanemariam; Ilesanmi, A. O.; Aimakhu, CO; Mulugeta, Afework

doi:10.21203/rs.2.14708/v3

Cited by 4 publications

(7 citation statements)

References 22 publications

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“…High blood pressure in pregnancy is associated with adverse pregnancy outcomes for both mother and infant. Similar to findings from Ethiopia, we found that approximately a third of women classified as hypertensive at 1st ANC visit delivered preterm and LBW infants [ 40 ].…”

Section: Discussionsupporting

confidence: 84%

Blood pressure trajectories during pregnancy and associations with adverse birth outcomes among HIV-infected and HIV-uninfected women in South Africa: a group-based trajectory modelling approach

Malaba

Cois

Madlala

et al. 2020

BMC Pregnancy Childbirth

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Background High blood pressure (BP) late in pregnancy is associated with preterm delivery (PTD); BP has also been associated with HIV and antiretroviral therapy (ART), but whether the relationship between BP assessed longitudinally over pregnancy and PTD and low birthweight (LBW) is modified by HIV/ART is unclear. We hypothesise the presence of distinctive BP trajectories and their association with adverse birth outcomes may be mediated by HIV/ART status. Methods We recruited pregnant women at a large primary care facility in Cape Town. BP was measured throughout pregnancy using automated monitors. Group-based trajectory modelling in women with ≥3 BP measurements identified distinct joint systolic and diastolic BP trajectory groups. Multinomial regression assessed BP trajectory group associations with HIV/ART status, and Poisson regression with robust error variance was used to assess risk of PTD and LBW. Results Of the 1583 women in this analysis, 37% were HIV-infected. Seven joint trajectory group combinations were identified, which were categorised as normal (50%), low normal (25%), high normal (20%), and abnormal (5%). A higher proportion of women in the low normal group were HIV-infected than HIV-uninfected (28% vs. 23%), however differences were not statistically significant (RR 1.27, 95% CI 0.98–1.63, reference category: normal). In multivariable analyses, low normal trajectory (aRR0.59, 0.41–0.85) was associated with decreased risk of PTD, while high normal (aRR1.48, 1.12–1.95) and abnormal trajectories (aRR3.18, 2.32–4.37) were associated with increased risk of PTD, and abnormal with increased risk of LBW (RR2.81, 1.90–4.15). Conclusions While HIV/ART did not appear to mediate the BP trajectories and adverse birth outcomes association, they did provide more detailed insights into the relationship between BP, PTD and LBW for HIV-infected and uninfected women.

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Section: Discussionsupporting

confidence: 84%

Blood pressure trajectories during pregnancy and associations with adverse birth outcomes among HIV-infected and HIV-uninfected women in South Africa: a group-based trajectory modelling approach

Malaba

Cois

Madlala

et al. 2020

BMC Pregnancy Childbirth

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“…Based on our inclusion criteria, only 25 articles were included and considered for final analysis. From those included studies, eight articles were done in Amhara region [ 20 , 32 , 33 , 39 – 43 ], seven in SNNP [ 31 , 44 – 49 ], four articles in AA [ 50 – 53 ] and Oromo [ 25 , 54 – 56 ] for each and one article in Tigray [ 57 ] and Ethiopian Somalia region [ 58 ] for each. Concerning to publication, one study was un-published (grey literature) [ 40 ] whereas the remaining 24 articles were published from 2005 to 2020 in different journals [ 20 , 25 , 31 – 33 , 39 , 41 – 50 , 52 , 53 , 55 – 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…Concerning to publication, one study was un-published (grey literature) [ 40 ] whereas the remaining 24 articles were published from 2005 to 2020 in different journals [ 20 , 25 , 31 – 33 , 39 , 41 – 50 , 52 , 53 , 55 – 58 ]. Regarding to study design, 15 articles were employed cross sectional [ 20 , 25 , 31 , 39 , 41 – 43 , 47 – 51 , 53 – 56 ] while the five studies were done using cohort [ 33 , 45 , 50 , 57 , 58 ] and case control design [ 32 , 40 , 44 , 46 , 52 ] for each studies scored five and above out of settled criteria for each study design according to JBI critical appraisal were included for this systematic review and meta analysis (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Regarding to study design, 15 articles were employed cross sectional [ 20 , 25 , 31 , 39 , 41 – 43 , 47 – 51 , 53 – 56 ] while the five studies were done using cohort [ 33 , 45 , 50 , 57 , 58 ] and case control design [ 32 , 40 , 44 , 46 , 52 ] for each studies scored five and above out of settled criteria for each study design according to JBI critical appraisal were included for this systematic review and meta analysis (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

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The impact of pregnancy induced hypertension on low birth weight in Ethiopia: systematic review and meta-analysis

2020

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Background Even though neonatal mortality reduction is the major goal needed to be achieved by 2030, it is still unacceptably high especially in Ethiopia. In the other hand, low birth weight is the major cause of neonatal mortality and morbidity. More than 10 millions of low birth weight infants occurred as a result of pregnancy induced hypertension. However, in Ethiopia the association between low birth weight and pregnancy induced hypertension was represented with un-updated, inconclusive and different studies. Therefore, this review aimed to estimate the overall pooled impact of pregnancy induced hypertension on low birth weight and its association in Ethiopia. Methods articles searched on PubMed/Medline, EMBASE, CINAHL, Cochrane library, Google, Google Scholar and local shelves. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was applied for critical appraisal. The I2 statistic was computed to check the presence of heterogeneity. Publication bias was evaluated using funnel plot asymmetry and Egger’s test. A random effect model was used to estimate the pooled prevalence of low birth weight. Result From the total 131 identified original articles, 25 were eligible and included for the final analysis. The overall pooled prevalence of low birth weight among women who had pregnancy induced hypertension in Ethiopia was 39.7% (95% CI: 33.3, 46.2). But, I2 statistic estimation evidenced significant heterogeneity across included studies (I2 = 89.4, p < 0.001). In addition, the odds of having low birth weight newborns among women who had pregnancy induced hypertension was 3.89 times higher compared to their counterparts (OR = 3.89, 95% CI: 2.66, 5.69). Conclusion The pooled prevalence of low birth weight among women who had pregnancy induced hypertension was more than two times higher than the pooled estimate of low birth weight among all reproductive aged women. The odds of low birth weight also increased nearly four times among women with pregnancy induced hypertension than normotensive women. Therefore, health policies which provide better and quality antenatal care with more oriented on importance of early detection and management of pregnancy induced hypertension should be implemented.

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“…There are several possible pathways to explain the observed protective effect of ANC attendance on the adverse pregnancy outcomes assessed in this study. First, antenatal care provides an opportunity for the early detection and appropriate management of pregnancy-related complications such as anaemia, malaria, gestational diabetes, infections, hypertension which are known to cause preterm birth, stillbirth, low birth weight, and small-for-gestational-age (40)(41)(42). Through antenatal assessment, women with these risk factors are identi ed and advised on the signs of complications, birth preparedness, and offered distinct attention to prevent adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Association between antenatal care visits and adverse pregnancy outcomes: a retrospective cross-sectional study among Ghanaian women

Abukari

Mohammed²,

Yakubu

et al. 2021

Preprint

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Background The study aimed to determine the association between antenatal visits and adverse pregnancy outcomes among Ghanaian women in the North East Region.Methods We analysed data on the birth records of 2907 women who delivered at Baptist Medical Centre between January 2018 to December 2018. Binary logistic regression was used to assess the association between antenatal visits and four adverse pregnancy outcomes – preterm birth, low birth weight, small-for-gestational-age, and stillbirth. Results Our analysis showed that ANC attendance offered some protection against preterm birth, low birth weight, small-for-gestational-age, and stillbirth in the study sample, albeit with variations in the protective effect depending on the number of visits attended. An increase in the number of ANC visits was associated with a decrease in the occurrence of the adverse pregnancy outcomes, except for low birth weight where the protective effect was observed only after four ANC visits. Adolescent mothers attended the least number of ANC visits during the study period. Our analysis suggests that the effect of ANC attendance on preterm birth and low birth weight differed depending on the age of the mother. Among mothers who never attended any ANC visits, adolescent mothers and older mothers had higher odds of low birth weight compared to mothers aged 20-30years. Surprisingly, the odds of preterm birth among the mothers who never attended any ANC visits was lower in adolescent mothers and older mothers compared to mothers aged 20-30years. For mothers who attended four or more ANC visits, the odds of low birth weight were higher in adolescent mothers and lower in older mothers compared to mothers aged 20-30years. However, the odds of preterm birth among the mothers who attended more than four ANC visits was higher in adolescent mothers and older mothers compared to mothers aged 20-30years. Conclusion The findings highlight the importance of ANC in preventing adverse pregnancy outcomes and the need for every pregnant woman to initiate and ensure adequate ANC contacts. The results also highlight the need to prioritise adolescents and older pregnant women for ANC.

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

Cited by 4 publications

References 22 publications

Blood pressure trajectories during pregnancy and associations with adverse birth outcomes among HIV-infected and HIV-uninfected women in South Africa: a group-based trajectory modelling approach

Blood pressure trajectories during pregnancy and associations with adverse birth outcomes among HIV-infected and HIV-uninfected women in South Africa: a group-based trajectory modelling approach

The impact of pregnancy induced hypertension on low birth weight in Ethiopia: systematic review and meta-analysis

Association between antenatal care visits and adverse pregnancy outcomes: a retrospective cross-sectional study among Ghanaian women

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