Prevalence of pregnancy hypertensive disorders in Mongolia

Abstract

Objective To estimate the prevalence of preeclampsia in a contemporary population of Mongolian women living in urban and rural areas. We determined the sensitivity and specificity of diagnosis based on established diagnostic criteria and assessed whether local diagnostic criteria were similar to those used in the US. Study Design Cross-sectional study of urban and nomadic pregnant women recruited in Ulaanbaatar (n=136) and rural provinces (n=85). Main Outcome Measures Preeclampsia defined as hypertension new to pregnancy after 20 weeks and proteinuria (or protein creatinine ratio ≥0.3 and dipstick reading >+1) or in the absence of proteinuria, hypertension and onset of: renal insufficiency, impaired liver function, thrombocytopenia, pulmonary edema, cerebral/visual symptoms. Prevalence of preeclampsia based on established criteria was compared with prevalence based on local physician’s diagnosis. Results Prevalence of local physician diagnosed preeclampsia was 9.5% (13.2% urban, 3.5% rural). Prevalence based on established diagnostic criteria was 4.1% (4.4% urban, 3.5% rural). Sensitivity of physician’s diagnosis was 23.8%, specificity was 98.0%, false negative rate was 2.0% and false positive rate was 76.2%. While prevalence based on local physician’s diagnosis was over double that based on diagnostic criteria, overdiagnosis did not result in adverse effects. Women fulfilling diagnostic criteria for preeclampsia had babies with higher birth weights than women who did not (p-value=0.006). Conclusion The 4.1% prevalence of preeclampsia in Mongolia was consistent with global estimates of 2–8%, suggesting the pathophysiology of preeclampsia here may be similar to that found globally. Sensitivity of physician’s diagnosis was low, specificity was high.

Patterns of Hypertensive Disorders of Pregnancy in Selected Hospitals of Tigray, Ethiopia

“…The prevalence of preeclampsia and eclampsia among all deliveries were 2.2% and 0.7% respectively which is consistent with the 2.13 % for preeclampsia in Iran [20] but lower than the finding in Mongolia where by researchers reported 4.1% prevalence of preeclampsia [27]. The 0.7% prevalence of eclampsia in this study is higher than the one reported in Iran (0.03%) [20].…”

A Review of the Potential Benefits of Increasing Vitamin D Status in Mongolian Adults through Food Fortification and Vitamin D Supplementation

“…Pregnant women in Mongolia were found to have preeclampsia rates of about 4% (4.4% in Ulaanbaatar and 3.5% in rural regions) [101]—an important risk factor for preterm birth and low birth weight [102]. A meta-analysis involving 21 studies reported that low vs. high maternal 25(OH)D concentration was associated with an OR of 1.62 (95% CI, 1.36 to 1.94) for preeclampsia [75], the OR for the Asian sub-population being 2.07 (95% CI, 1.51 to 2.85).…”

Impact assessment of a raw coal ban on maternal and child health outcomes in Ulaanbaatar: a protocol for an interrupted time series study

“…Expected weekly counts for key pregnancy outcomes such as low birth weight (4.5% of births), pre-eclampsia (4.1% of pregnancies) and spontaneous abortion (5% of pregnancies) in Ulaanbaatar are 35, 32 and 38, respectively, based on country-specific data. [25][26][27] Furthermore, considering the introduction of the pneumococcal vaccine in July 2016, historic data on seasonal pneumonia patterns in Mongolia and the latest Mongolian Multiple Indicator Cluster Survey data on child acute respiratory infection presentation, it is estimated that child under 5 respiratory admission rates will range between 2% and 10% for the summer and winter months, respectively. 21 28 29 Air quality assessment As a measure of Ulaanbaatar's air quality over the study period, routinely collected air pollution measurements of PM 2.5 , PM 10 , carbon monoxide, SO 2 , NOx and ozone concentrations (µg/m 3 ) will be obtained from the 17 air quality monitoring stations run by the GoM as well as one US Embassy air measurement station in Ulaanbaatar.…”