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: 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

1. Goldenberg RL, McClure EM, Macguire ER, Kamath BD, Jobe AH. Lessons for low-income regions following the reduction in hypertension-related maternal mortality in high-income countries. Int J Gynaecol Obstet. 2011;113(2):91–5. Epub 2011/02/26. S0020-7292(11)00046-4 [pii] doi: 10.1016/j.ijgo.2011.01.002 21349517.

2. Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33(3):130–7. Epub 2009/05/26. S0146-0005(09)00021-4 [pii] doi: 10.1053/j.semperi.2009.02.010 19464502.

3. Ekele BA, Bello SO, Adamu AN. Clusters of eclampsia in a Nigerian teaching hospital. Int J Gynaecol Obstet. 2007;96(1):62–6. Epub 2006/12/26. S0020-7292(06)00490-5 [pii] doi: 10.1016/j.ijgo.2006.09.027 17188273.

4. Lee QY, Odoi AT, Opare-Addo H, Dassah ET. Maternal mortality in Ghana: a hospital-based review. Acta Obstet Gynecol Scand. 2012;91(1):87–92. Epub 2011/07/29. doi: 10.1111/j.1600-0412.2011.01249.x 21793813.

5. Adu-Bonsaffoh K, Obed SA, Seffah JD. Maternal outcomes of hypertensive disorders in pregnancy at Korle Bu Teaching Hospital, Ghana. Int J Gynaecol Obstet. 2014;127(3):238–42. Epub 2014/08/12. S0020-7292(14)00372-5 [pii] doi: 10.1016/j.ijgo.2014.06.010 25108587.

6. Kwawununu FK, Morhe ES, Konney TO. Trends in maternal mortality at Komfo Anokye Teaching Hospital, Kumasi, Ghana, between 1998 and 2007. Int J Gynaecol Obstet. 2012;117(2):183–4. Epub 2012/02/22. S0020-7292(12)00028-8 [pii] doi: 10.1016/j.ijgo.2011.12.008 22342058.

7. Danso KA, Opare-Addo HS. Challenges associated with hypertensive disease during pregnancy in low-income countries. Int J Gynaecol Obstet. 2010;110(1):78–81. Epub 2010/04/07. S0020-7292(10)00103-7 [pii] doi: 10.1016/j.ijgo.2010.01.026 20362990.

8. Tuuli MG, Rampersad R, Stamilio D, Macones G, Odibo AO. Perinatal outcomes in women with preeclampsia and superimposed preeclampsia: do they differ? Am J Obstet Gynecol. 2011;204(6):508 e1–7. Epub 2011/03/23. S0002-9378(11)00158-X [pii] doi: 10.1016/j.ajog.2011.01.065 21419381.

9. Roberts CL, Algert CS, Morris JM, Ford JB, Henderson-Smart DJ. Hypertensive disorders in pregnancy: a population-based study. Med J Aust. 2005;182(7):332–5. Epub 2005/04/05. rob10821_fm [pii]. 15804223.

10. Ray JG, Burrows RF, Burrows EA, Vermeulen MJ. MOS HIP: McMaster outcome study of hypertension in pregnancy. Early Hum Dev. 2001;64(2):129–43. Epub 2001/07/07. S0378378201001815 [pii]. doi: 10.1016/s0378-3782(01)00181-5 11440825.

11. Olusanya BO, Solanke OA. Perinatal Outcomes Associated with Maternal Hypertensive Disorders of Pregnancy in a Developing Country. Hypertens Pregnancy. 2011;31(1):120–30. Epub 2011/01/12. doi: 10.3109/10641955.2010.525280 21219122.

12. Biostatistics Unit Department of Obstetrics and Gynaecology. Annual in-patient records for 2015. 2016.

13. Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertens. 2014;4(2):97–104. Epub 2014/04/01. doi: 10.1016/j.preghy.2014.02.001 26104417.

14. WHO. International statistical classification of diseases and related health problems, 10th revision. Geneva: WHO; 1993.

15. Crentsil EE. Risk Factors associated with eclampsia in patients with hypertensive disorders of pregnancy (HDP) in Komfo Anokye Teaching Hospital, Kumasi, Ghana [Fellowship Dissertation]: West African College of Surgeons; 2012.

16. Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365(9461):785–99. Epub 2005/03/01. S0140-6736(05)17987-2 [pii] doi: 10.1016/S0140-6736(05)17987-2 15733721.

17. Ghulmiyyah L, Sibai B. Maternal mortality from preeclampsia/eclampsia. Semin Perinatol. 2012;36(1):56–9. Epub 2012/01/28. S0146-0005(11)00157-1 [pii] doi: 10.1053/j.semperi.2011.09.011 22280867.

18. Adu-Bonsaffoh K, Ntumy MY, Obed SA, Seffah JD. Perinatal outcomes of hypertensive disorders in pregnancy at a tertiary hospital in Ghana. BMC Pregnancy Childbirth. 2017;17(1):388. Epub 2017/11/22. doi: 10.1186/s12884-017-1575-2 29157196; PubMed Central PMCID: PMC5696910.

19. Addo J, Agyemang C, Smeeth L, de-Graft Aikins A, Edusei AK, Ogedegbe O. A review of population-based studies on hypertension in Ghana. Ghana Med J. 2012;46(2 Suppl):4–11. Epub 2013/05/15. 23661811; PubMed Central PMCID: PMC3645150.

20. Adu-Bonsaffoh K, Samuel OA, Binlinla G. Maternal deaths attributable to hypertensive disorders in a tertiary hospital in Ghana. Int J Gynaecol Obstet. 2013;123(2):110–3. Epub 2013/08/24. S0020-7292(13)00370-6 [pii] doi: 10.1016/j.ijgo.2013.05.017 23969337.

21. Nathan HL, Seed PT, Hezelgrave NL, De Greeff A, Lawley E, Conti-Ramsden F, et al. Maternal and perinatal adverse outcomes in women with pre-eclampsia cared for at facility-level in South Africa: a prospective cohort study. J Glob Health. 2018;8(2):020401. Epub 2018/08/25. doi: 10.7189/jogh.08-020401 30140431.

22. Browne JL, van Nievelt SW, Srofenyoh EK, Grobbee DE, Klipstein-Grobusch K. Criteria-based audit of quality of care to women with severe pre-eclampsia and eclampsia in a referral hospital in Accra, Ghana. PLoS One. 2015;10(4):e0125749. Epub 2015/04/30. doi: 10.1371/journal.pone.0125749 25923663; PubMed Central PMCID: PMC4414498.

23. Tuncalp O, Hindin MJ, Adu-Bonsaffoh K, Adanu RM. Assessment of maternal near-miss and quality of care in a hospital-based study in Accra, Ghana. Int J Gynaecol Obstet. 2013;123(1):58–63. Epub 2013/07/09. S0020-7292(13)00277-4 [pii] doi: 10.1016/j.ijgo.2013.06.003 23830870.

24. Ngwenya S. Severe preeclampsia and eclampsia: incidence, complications, and perinatal outcomes at a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe. Int J Womens Health. 2017;9:353–7. Epub 2017/05/30. doi: 10.2147/IJWH.S131934 28553148; PubMed Central PMCID: PMC5439934.

25. Browne JL, Vissers KM, Antwi E, Srofenyoh EK, Van der Linden EL, Agyepong IA, et al. Perinatal outcomes after hypertensive disorders in pregnancy in a low resource setting. Trop Med Int Health. 2015;20(12):1778–86. Epub 2015/10/02. doi: 10.1111/tmi.12606 26426071.


Článek vyšel v časopise

PLOS One


2019 Číslo 10

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

Léčba bolesti v ordinaci praktického lékaře
nový kurz
Autoři: MUDr. PhDr. Zdeňka Nováková, Ph.D.

Revmatoidní artritida: včas a k cíli
Autoři: MUDr. Heřman Mann

Jistoty a nástrahy antikoagulační léčby aneb kardiolog - neurolog - farmakolog - nefrolog - právník diskutují
Autoři: doc. MUDr. Štěpán Havránek, Ph.D., prof. MUDr. Roman Herzig, Ph.D., doc. MUDr. Karel Urbánek, Ph.D., prim. MUDr. Jan Vachek, MUDr. et Mgr. Jolana Těšínová, Ph.D.

Léčba akutní pooperační bolesti
Autoři: doc. MUDr. Jiří Málek, CSc.

Nové antipsychotikum kariprazin v léčbě schizofrenie
Autoři: prof. MUDr. Cyril Höschl, DrSc., FRCPsych.

Všechny kurzy
Kurzy Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se