Factors associated with hypertensive disorders of pregnancy among pregnant women in Mukono District

Abstract

Introduction: Hypertensive disorders of pregnancy (HDP) include chronic hypertension, gestational hypertension, pre-eclampsia, eclampsia and chronic hypertension with superimposed pre-eclampsia. These disorders are associated with higher rates of maternal, fetal and infant mortality, and severe morbidity, especially in cases of severe pre-eclampsia, eclampsia. Routine measurement of Blood Pressure and urinalysis among all pregnant women is recommended at every ANC visit in developing countries (WHO 2003) to ensure timely diagnosis and treatment. In Mukono district HDPs are of major concern as contributor to maternal mortality. Objective: To identify the prevalence and factors associated with HDP among pregnant women in Mukono District in order to inform control programs on the priority factors and risk groups to address. Methodology: A cross-sectional study involving multi-stage sampling technique was applied to identify the required 372 study participants in Mukono district, central Uganda. The selected respondents were physically identified with the help of the Village Health Teams. Statistical analysis: Descriptive statistics and HDP prevalence and distribution was calculated. Factors associated with HDP were determined using logistic regression and a p-value of less than 0.05 was considered statistically significant. Results: 372 pregnant women were included in this study, respondents age ranged from 14 years to 41years with a mean age of 24 years (SD= ±4.78) 95%CI (23.8-24.8). The prevalence of Hypertensive Disorders of Pregnancy among the respondents was 16.67% (62/372) with majority being chronically hypertensive (61.29%; 38/62). Factors associated with hypertensive disorders of pregnancy include: Age; 31 years to 41years; (OR 5.64; 95%CI 1.60- 19.87), High diet diversity; (OR 0.23; 95% CI 0.09-0.55), none attendance of ANC; (OR 2.59; 95% CI 1.47-4.72) and primigravidae (OR 0.43; 95% CI 0.22-0.84) after controlling for confounding. Conclusion and recommendation: One in every six pregnant women in Mukono district has Hypertensive disorders of pregnancy. However 61.29% of these pregnant women have chronic hypertension and attendance of ANC at least once, age of the respondent, gravidity and diet diversity were found to be associated with Hypertensive Disorders of Pregnancy in Mukono district. The District health Team should put in place strategies to ensure proper and adequate implementation of the WHO guidelines to prevention and manage hypertension among pregnant women.