Incidence of gestational hypertension among pregnant women (2006-2015) in Enugu State, Southeast Nigeria: a retrospective study

Abstract

INTRODUCTIONGestational hypertension (GHTN), formerly known as pregnancy induced hypertension, is defined as a new rise in blood pressure (BP) ≥140/90mm Hg, presenting at or after 20 weeks gestation without significant proteinuria (≥ 300mg/24 hour urine collection of urine, or 2 specimens of urine collected ≥ 4 hours apart with ≥ 2+ on the protein reagent strip, or protein creatinine ratio (PCR) ˃ 30mg/mmol) or other features of preeclampsia which usually resolves within 6-12 weeks of delivery.1,2 It is the most frequent cause of hypertension during pregnancy, constituting approximately 70%, and complicating about 6-17% pregnancies in healthy nulliparous women and 2-4% in multiparous women.3 Its incidence varies with the age and parity of the pregnant woman, being higher in younger nulliparous than older multiparous pregnant women. ABSTRACTBackground: Gestational hypertension (GHTN) is defined as a new rise in blood pressure (BP) ≥140/90 mm Hg, presenting at 20 weeks gestation without significant proteinuria. Worldwide, 4.4%-15% of all pregnancies are complicated by HTN. The aim of this study was to determine the incidence of GHTN among pregnant women in Enugu State, Southeast Nigeria with a view to improving and strengthening antenatal services in the State to help reduce the proportion of maternal mortality and fetal outcomes attributable to GHTN and reduce the overall prevalence of HTN in the country. Methods: Records of BP, biodata and laboratory investigations (urinalysis, full blood count) of women who attended antenatal clinics in six selected state hospitals (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) were examined. Data were analyzed as proportions, t-test, ANOVA and Pearson product moment correlations using Maxstat (version 3.60) statistical software. Results: The overall incidence of GHTN was 5.9% with annual fluctuations with peaks in 2010 and 2014. There were significant differences in incidence among the age groups (<20 years, 20-35 years and >35 years) (p<0.0001) and between nulliparous and multiparous women (p=0.0016). There was positive, strong and significant correlation between age (20-35 years and >35 years) and GHTN (r=0.932, p=0.0069). Between parity and GHTN, there was also positive, strong and significant correlation (r=0.813, p=0.0491). Conclusions: With an incidence of GHTN at 5.9%, there is need to improve and sustain adequate antenatal services in order to help reduce the proportion of the country's maternal mortality attributable to hypertensive disorders of pregnancy.

A retrospective study of socio-demographic factors in pregnancy induced hypertension in a tertiary care hospital in eastern India

“…In this study, majority of cases admitted with PIH were primigravida (65%). In a retrospective study conducted in southeast Nigeria by Umegbolu EI et al, the incidence of PIH was higher among nulliparous women (7.7%) as compared to (5.5%) in multiparous women [18] . In a study by Shikha Saxena et al also the majority of cases were primigravida (57%) [15] .…”

Assessment of serum, dietary zinc levels, and other risk factors during the third trimester among pregnant women with and without pregnancy-induced hypertension: a case-control study

“…This is consistent with the results of our study. Umegbolu and Ogamba ( 42 ) reported that first pregnancy is a risk factor for PIH and its occurrence is more common in nulliparous than multiparous women. Howell ( 43 ) showed that in women with prior cesarean delivery, PIH was significantly higher.…”

An Investigation of Exosome Concentration and Exosomal microRNA (miR-155 and miR-222) Expression in Pregnant Women with Gestational Hypertension and Preeclampsia

“…GH was defined as a blood pressure of ≥140/90mmHg with no proteinuria. 23 Late-onset PE was defined as a sustained blood pressure of ≥140/90 mmHg with proteinuria of at least 300 mg after 34 weeks of pregnancy. 1 …”