Factors associated with hypertension during pregnancy in women giving birth in Lusaka, Zambia

Abstract

Abstract Factors associated with hypertension during pregnancy in women giving birth in Lusaka, Zambia Beatrice Bergdahl, Degree project, Programme in Medicine, 2018. Dept. of Obstetrics and Gynaecology, UTH, Lusaka, Zambia. Håkan Lilja, Associate professor, Dept. of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg. Bellington Vwalika, Associate professor of Obstetrics and Gynaecology, Dept. of Obstetrics and Gynaecology, University Teaching hospital. Patrick Musonda, Associate professor of Medical Statistics, School of Public Health, University of Zambia. Background: In 2015, the country of Zambia still had a very high maternal mortality rate, 224 per 100,000 live births. Globally, 14 per cent of all maternal deaths is related to hypertension. In order to prevent hypertension during pregnancy risk patients have to be identified. Aim: To give enlarged information about the proportion of various hypertensive disorders during pregnancy and their specific risk factors in women who gave birth in Lusaka, Zambia. Method: A retrospective cross-sectional study was conducted using secondary data from Zambia Electronic Perinatal Record System (ZEPRS) on women who attended antenatal care and delivered in Lusaka between January 1st, 2008 and December 31st, 2012. Results: 104,936 women were included in the study. 15 per cent of maternal deaths were connected to hypertension. 8 per cent had some kind of hypertension. The proportion of various hypertensive disorders were; Chronic hypertension (1.74 %), gestational hypertension (4.02 %), preeclampsia (2.19 %) and eclampsia (0.06 %). Independent risk factors for any type of hypertension was an increasing BMI over 25 and taking more than one dose of malaria prophylaxis. Multiple pregnancy and nulliparity were significant predictors for developing preeclampsia. Conclusion: The number of maternal deaths caused by hypertension has decreased and the frequency of hypertension during pregnancy was in accordance with the global average. The incidence of the different kind of hypertensive disorder was lower than expected. Risk factors in Zambian women did not differ from other studies. Early and regular blood pressure, proteinuria measurements and increased monitoring in nulliparous, women having a multiple pregnancy or a BMI over 25 is crucial due to their amplified risk for the hypertensive complications.