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Maternal and perinatal outcomes among women with hypertensive disorders in pregnancy in Kumasi, Ghana


Autoři: Edward T. Dassah aff001;  Eunice Kusi-Mensah aff003;  Emmanuel S. K. Morhe aff004;  Alexander T. Odoi aff002
Působiště autorů: School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana aff001;  Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana aff002;  Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana aff003;  School of Medicine, University of Health and Allied Sciences, Ho, Ghana aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223478

Souhrn

Background

Data pertaining to maternal and perinatal outcomes associated with the complete spectrum of hypertensive disorders in pregnancy (HDPs) is sparse in low resource settings. This study aimed to determine adverse maternal and perinatal outcomes among women admitted with HDPs in a tertiary hospital in Ghana, and directly compare these outcomes among women with pre-eclampsia/eclampsia and those with chronic/gestational hypertension.

Methods

An analytical cross-sectional study was conducted among women who were admitted with HDPs to Komfo Anokye Teaching Hospital from July 1, 2014 to September 30, 2014. Data was collected on their socio-demographic and reproductive characteristics using a pretested structured questionnaire and review of their antenatal records. Crude and adjusted relative risks (RRs), with 95% confidence intervals (CIs), associated with adverse maternal and perinatal outcomes were compared using multivariable binomial regression. P ≤0.05 was considered statistically significant.

Results

A total of 451 women with HDPs were studied: 5.3%, 32.4%, 48.8% and 13.5% had chronic hypertension, gestational hypertension, pre-eclampsia and eclampsia respectively. Over 80% were either referrals or “self-referred” from other facilities. Overall, 87% had adverse maternal or perinatal outcomes. Women with pre-eclampsia/eclampsia were at increased risks of caesarean section (adjusted RR, 1.37; 95% CI, 1.01–1.87), preterm delivery at <34 weeks’ gestation (adjusted RR, 2.74; 95% CI, 1.40–5.36) and preterm delivery at <37 weeks’ gestation (adjusted RR, 1.89; 95% CI, 1.25–2.85), compared to women with chronic/gestational hypertension.

Conclusion

Women with pre-eclampsia/eclampsia were at higher risk of adverse pregnancy outcome compared to those with chronic/gestational hypertension. Strategies for prevention and management of pre-eclampsia/eclampsia to improve pregnancy outcomes are required in this major maternity care centre.

Klíčová slova:

Antenatal care – Hypertension – Hypertensive disorders in pregnancy – Labor and delivery – Preeclampsia – Pregnancy – Preterm birth – Eclampsia


Zdroje

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