Prevalence and factors associated with undiagnosed chronic hypertension in pregnancy among women attending antenatal clinic in Kawempe national referal hospital.

Abstract

Undiagnosed chronic hypertension in pregnancy refers to high blood pressures of 140/90 mmhg and above detected before pregnancy or present before 20 weeks of gestation and has never been diagnosed or treated before.Chronic hypertension in pregnancy is associated with high risk of predisposition to preeclampsia/ eclampsia, intrauterine growth restriction, placental abruption, preterm birth and increased risk of caesarean section. The aim of the study was to determine the prevalence and factors associated with undiagnosed chronic hypertension in pregnancy among women attending ANC in Kawempe National Referral hospital. METHODS: This was a hospital based cross-sectional study conducted in the antenatal clinic of Kawempe National Referral Hospital. A total of 384 participants who were attending their ANC visit were recruited in the study using consecutive sampling method. Data was obtained by an interviewer administered questionnaire and additional information was obtained from the patient’s records. The criterion that was used to diagnose chronic hypertension in pregnancy was elevated blood pressure (BP) that was present and documented before pregnancy. If the pre-pregnancy Blood Pressure was unknown, the diagnosis was based on the presence of sustained hypertension before 20 weeks’ gestation, defined as either systolic BP of at least 140 mm Hg or diastolic BP of at least 90 mm Hg on at least two occasions measured at least 4 hours apart. Gestational age was determined basing on the last normal menstrual period (LNMP) and 1st trimester ultrasound scan.Data was entered and cleaned using EpiData Version 3.1 and then exported to Statistical Package for Social Science (Version 16) for further analysis. RESULTS: Prevalence of undiagnosed chronic hypertension in pregnancy in Kawempe National Referral Hospital is 13%.

At multivariate analysis, BMI was associated with undiagnosed chronic hypertension in pregnancy (AOR: 3.68, 95%CI: 1.49-9.13, P=0.005), Women who had been managed for hypertensive disorder in pregnancy before (AOR: 5.03, 95% CI: 1.63-15.49, P value 0.005), having gravidity of 1-2 were significantly more likely to have undiagnosed chronic hypertension in pregnancy [AOR: 2.68, CI (1.09-6.61), p value 0.032. CONCLUSIONS

The prevalence of undiagnosed chronic hypertension in pregnancy in this study was found to be 13% Women with history of hypertension in previous pregnancy are 5 times more likely to have undiagnosed hypertension in pregnancy Other factors significantly associated with undiagnosed chronic hypertension in pregnancy were BMI, 1st and 2nd pregnancy Key words: chronic hypertension, pregnancy less than 20 weeks, associated factors