Prevalence and Risk Factors Associated With Preeclampsia, Low Birth Weight and Postpartum Hemorrhage in Northern Ghana

Abstract

Background: The study evaluated the risks for developing low birth weight (LBW), preeclampsia (PE) and postpartum hemorrhage (PPH) in relation to maternal socio-demographic, obstetric characteristics and clinical laboratory information obtained at 1st antenatal care (ANC) visit.Methods: The study included 268 pregnant women attending 1st ANC visit at the Bolgatanga Regional Hospital. Structured questionnaires were used to obtain socio-demographic and obstetric data from respondents. The main variables were LBW, PPH, PE, mode of delivery, residency, gestational age at 1st ANC visit, maternal age, sickling positivity, Hb at 1st ANC visit, Hb genotype and G6PD status. Odds ratio [OR, 95% confidence interval (CI)] for the association between sociodemographic, obstetric characteristics and clinical variables in relation to PE, LBW and PPH were assessed using logistic regression model.Results: The prevalence of PE, LBW and PPH were 25.4% (68/268), 15.7% (42/268) and 6.0% (16/268), respectively. For PE, delayed 1st ANC visit (AOR=16.82, 95% CI (3.61-78.5), p=0.000) and younger maternal age (AOR= 15.19, 95% CI (1.85-124.56), p=0.011) were independently associated with higher odds whereas vaginal delivery (AOR=0.32, 95% CI (0.15-0.71), p=0.015) was independently associated with reduced odds. Delayed 1st ANC visit (AOR=0.12, 95% CI (0.03-0.47)), p=0.002) independently reduced the risk of PPH whereas the male gender (AOR=7.75, 95% CI (1.60-37.51), p=0.011) independently increased the risk of PPH. Lastly, delayed 1st ANC visit (AOR=3.26, 95% CI (1.05-10.10), p=0.041) was independently associated with increased odds of LBW whereas vaginal delivery (AOR=0.36, 95% CI (0.17-0.74), p=0.006) was an independent risk factor for LBW in the multivariate model.Conclusion: The study identified delayed ANC visit as an independent risk factor for PE, LBW and PPH in Northern Ghana. Vaginal delivery and younger maternal age were also independent risk factors for PE. Additionally, the male gender was independently associated with PPH whereas vaginal delivery was independently associated with LBW. We recommend that public health education for pregnant women that highlights the importance of early ANC visit be enhanced. This will facilitate early identification and intervention for women with risk of foeto-maternal complications. Younger women should be educated on the dangers 48 of early marriages with its attendant foeto-maternal complications.

Prevalence of preeclampsia and algorithm of adverse foeto-maternal risk factors among pregnant women in the Central Region of Ghana: A multicentre prospective cross-sectional study

“…Conversely, the prevalence reported in this study is higher than in other cross-sectional studies in Germany (2.31%) [ 31 ], Norway (3.0%) [ 32 ], Dilla, Ethiopia (2.23%) [ 33 ], and Accra, Ghana (7.03%, 7.9%) [ 8 , 34 ]. In contrast to other previous studies, the findings of this study found a lower prevalence as compared to 12.4% in Ethiopia [ 7 ], 16% in Nigeria [ 35 ], 25.4% in Ghana [ 36 ] and 51.9% in Ethiopia [ 37 ]. The differences in the prevalence could be attributed to different study settings, methodological variations, and seasonal variations.…”

Prevalence of Low Birth Weight and its Association With Anemia in White Nile State, Sudan: A Cross-Sectional Study

“…The current study showed that gestational age was inversely associated with LBW (AOR = 0.80), which means that every one-week increase in the gestational maturity of the neonate can decrease the chances of LBW by 20%. These findings concur with previous studies conducted in Khartoum, Sudan (Ahmed, 2022;Bilal et al, 2022) and other African countries, such as Ghana (Ahenkorah et al, 2022). Nevertheless, it is difficult to isolate the effect of gestational age alone on LBW in the presence of other poor maternal and perinatal factors, such as preterm birth, which is frequently observed in sub-Saharan countries and constitutes a major health problem (Young et al, 2023).…”

“…The prevalence (15.8%) of LBW in the current study is comparable to the prevalence of LBW reported for Eastern Sudan (15.3%; Adam et al, 2008) and Darfur, Western Sudan (14.9%; Haggaz et al, 2010). However, the prevalence was slightly higher than that reported for Khartoum, Sudan (12.1%; Bilal et al, 2022), Wad Medani (Central Sudan: 12.6%; Elhassan et al, 2010), Addis Ababa, Ethiopia (13.06%; Tadesse et al, 2023), Ghana (13.5%; Ahenkorah et al, 2022), and Tanzania (21%; Kamala et al, 2018). A pooled prevalence of 5.7% for LBW was recently reported in the Demographic and Health Survey of Saharan African countries, which enrolled 33,585 newborns (Weyori et al, 2022).…”

“…Despite continuing preventive measures, there is still a high prevalence of LBW in different countries in the sub-Saharan African region, including Sudan (Adam et al, 2008;Ahenkorah et al, 2022;Ahmed, 2022;Barut and Mohamud, 2023;Elhassan et al, 2010;Haggaz et al, 2010;Kamala et al, 2018;Kargbo et al, 2021;Odongkara et al, 2022;Tadesse et al, 2023;Wondemagegn et al, 2022). Several maternal factors, such as age (Odongkara et al, 2022), parity, level of antenatal care (ANC; Kamala et al, 2018), anemia (Barut and Mohamud, 2023;Kargbo et al, 2021;Odongkara et al, 2022;Tadesse et al, 2023), malarial infection (Odongkara et al, 2022), and malnutrition (Ahmed, 2022;Wondemagegn et al, 2022), as well as the neonate's gestational age (Ahenkorah et al, 2022;Ahmed, 2022), are reportedly associated with LBW in sub-Saharan Africa.…”