Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug;131(Suppl 3):42-54.
doi: 10.1111/1471-0528.17902. Epub 2024 Jul 3.

Predictors, prevalence and outcome of hypertensive disorders in pregnancy in Nigerian tertiary health facilities

Aisha Abdurrahman  1 , Aisha Nana Adamu  2 , Adewale Ashimi  3 , Oguntayo O Adekunle  4 , Stephen B Bature  5 , Labaran D Aliyu  6 , Owodunni Akeem  7 , Hauwa Abdullahi  6 , Tina Lavin  8 , Sulaiman Daneji  6 , Basiru Musa  2 , Zulkiflu Muazu  9 , Jamilu Tukur  6 , Hadiza Shehu Galadanci  6   10
Affiliations

Predictors, prevalence and outcome of hypertensive disorders in pregnancy in Nigerian tertiary health facilities

Aisha Abdurrahman et al. BJOG. 2024 Aug.

Abstract

Objective: Determine prevalence, risk factors and outcomes of hypertensive disorders in pregnancy (HDP).

Design: Cross-sectional analysis of data captured in the Maternal and Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) between September 2019 and August 2020.

Setting: Fifty-four referral level facilities in Nigeria.

Population: Women whose pregnancy ended (irrespective of the location or duration of pregnancy) or who were admitted within 42 days of delivery.

Methods: Descriptive statistics and multilevel mixed-effects logistic regression models.

Main outcome measures: Prevalence of HDP, sociodemographic and clinical factors associated with HDP and perinatal outcomes.

Results: Among the 71 758 women 6.4% had HDP and gestational hypertension accounted for 49.8%. Preeclampsia and eclampsia were observed in 9.5% and 7.0% of all pregnancies, respectively. The predictors of HDP were age over 35 years (OR1.96, 95% CI 1.82-2.12; p < 0.001), lack of formal educational (OR 1.18, 95% CI 1.06-1.32; p = 0.002), primary level of education (OR 1.20, 95% CI 1.03-1.4; p < 0.002), nulliparity (OR 1.21, 95% CI 1.12-1.31; p < 0.001), grand-multiparity (OR 1.36, 95%CI 1.21-1.52; p < 0.001), previous caesarean section (OR 1.26, 95%CI 1.15-1.38; p < 0.001) and previous miscarriage (OR 1.22, 95% CI 1.13-1.31; p < 0.001). Overall 3.7% of the patients with HDP died, with eclampsia having the highest case fatality rate of 27.9%. Stillbirth occurred in 11.9% of pregnancies with hypertensive disorders.

Conclusions: Hypertensive disorders in pregnancy are not uncommon in Nigeria. They are associated with adverse outcomes with over one-quarter of women with eclampsia dying. The main predictors include older age, poor education, extremes of parity and previous CS or miscarriage. Maternal and perinatal outcomes are poor with about a quarter developing complications and about 1 in 10 having stillbirths.

Keywords: hypertensive disorders in pregnancy; outcomes; predictors; tertiary health facilities.

PubMed Disclaimer

References

REFERENCES

    1. World Health Organization. Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations population division. Geneva: World Health Organization; 2019. www.who.int/reproductivehealth/publications/maternal‐mortality‐2017/en/
    1. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–e333. https://doi.org/10.1016/S2214‐109X(14)70227‐X
    1. Musarandega R, Nyakura M, Machekano R, Pattison R, Munjanja SP. Causes of maternal mortality in sub‐Saharan Africa: a systematic review of studies published from 2015 to 2020. J Glob Health. 2021;11:04048.
    1. Adamu AN, Okusanya BO, Tukur J, Ashimi AO, Oguntayo OA, Tunau KA, et al. Maternal near‐miss and death among women with hypertensive disorders in pregnancy: a secondary analysis of the Nigeria near‐miss and maternal death survey. Br J Obstet Gynaecol. 2018;126(S3):12–18. https://doi.org/10.1111/1471‐0528.15427
    1. Tukur J, Umar BA, Rabi'u A. Pattern of eclampsia in a tertiary health facility situated in a semi‐rural town in northern Nigeria. Ann Afr Med. 2007;6(4):164–167. https://doi.org/10.4103/1596‐3519.55703

LinkOut - more resources