TY - JOUR
T1 - Persistent hypertension up to one year postpartum among women with hypertensive disorders in pregnancy in a low-resource setting
T2 - A prospective cohort study
AU - Ishaku, Salisu M.
AU - Jamilu, Tukur
AU - Innocent, Agbo P.
AU - Gbenga, Kayode A.
AU - Lamaran, Dattijo
AU - Lawal, Oyeneyin
AU - Warren, Charlotte E.
AU - Olorunfemi, Owa O.
AU - Abubakar, Hanifah D.
AU - Karima, Tunau
AU - Patience, Odusolu O.
AU - Musa, Abdulkarim
AU - Azubuike, Onyebuchi K.
AU - Baffah, Aminu M.
AU - Franx, Arie
AU - Grobbee, Diederick E.
AU - Browne, Joyce L.
N1 - Funding Information:
This work was supported by the US Agency for International Development (USAID), under the terms of cooperative agreement number [USAID APSOAA-14-000048] through the Ending Eclampsia Project led by Population Council. This article reflects the views of the authors and does not represent the views of the U.S. Government. It was also supported by the UMC Utrecht Global Health Fellowship Program.
Publisher Copyright:
© 2021 The Author(s)
PY - 2021/9/9
Y1 - 2021/9/9
N2 - Background: Hypertensive disorders in pregnancy (HDPs) are associated with lifelong cardiovascular disease risk. Persistent postpartum hypertension in HDPs could suggest progression to chronic hypertension. This phenomenon has not been well examined in low- and middle-income countries (LIMCs), and most previous follow-ups typically last for maximally six weeks postpartum. We assessed the prevalence of persistent hypertension up to one year in women with HDPs in a low resource setting and determined associated risk factors. Methodology: A prospective cohort study of women conducted at eight tertiary health care facilities in seven states of Nigeria. Four hundred and ten women with any HDP were enrolled within 24 hours of delivery and followed up at intervals until one year postpartum. Descriptive statistics were performed to express the participants’ characteristics. Univariable and multivariable logistic regressions were conducted to identify associated risk factors. Results: Of the 410 women enrolled, 278 were followed up to one year after delivery (follow-up rate 68%). Among women diagnosed with gestational hypertension and pre-eclampsia/ eclampsia, 22.3% (95% CI; 8.3–36.3) and 62.1% (95% CI; 52.5–71.9), respectively, had persistent hypertension at six months and this remained similar at one year 22.3% (95% CI; 5.6–54.4) and 61.2% (95% CI; 40.6–77.8). Maternal age and body mass index were significant risk factors for persistent hypertension at one year [aORs = 1.07/year (95% CI; 1.02–1.13) and 1.06/kg/m2 (95% CI; 1.01–1.10)], respectively. Conclusion: This study showed a substantial prevalence of persistent hypertension beyond puerperium. Health systems in LMICs need to be organized to anticipate and maintain postpartum monitoring until blood pressure is normalized, or women referred or discharged to family physicians as appropriate. In particular, attention should be given to women who are obese, and or of higher maternal age.
AB - Background: Hypertensive disorders in pregnancy (HDPs) are associated with lifelong cardiovascular disease risk. Persistent postpartum hypertension in HDPs could suggest progression to chronic hypertension. This phenomenon has not been well examined in low- and middle-income countries (LIMCs), and most previous follow-ups typically last for maximally six weeks postpartum. We assessed the prevalence of persistent hypertension up to one year in women with HDPs in a low resource setting and determined associated risk factors. Methodology: A prospective cohort study of women conducted at eight tertiary health care facilities in seven states of Nigeria. Four hundred and ten women with any HDP were enrolled within 24 hours of delivery and followed up at intervals until one year postpartum. Descriptive statistics were performed to express the participants’ characteristics. Univariable and multivariable logistic regressions were conducted to identify associated risk factors. Results: Of the 410 women enrolled, 278 were followed up to one year after delivery (follow-up rate 68%). Among women diagnosed with gestational hypertension and pre-eclampsia/ eclampsia, 22.3% (95% CI; 8.3–36.3) and 62.1% (95% CI; 52.5–71.9), respectively, had persistent hypertension at six months and this remained similar at one year 22.3% (95% CI; 5.6–54.4) and 61.2% (95% CI; 40.6–77.8). Maternal age and body mass index were significant risk factors for persistent hypertension at one year [aORs = 1.07/year (95% CI; 1.02–1.13) and 1.06/kg/m2 (95% CI; 1.01–1.10)], respectively. Conclusion: This study showed a substantial prevalence of persistent hypertension beyond puerperium. Health systems in LMICs need to be organized to anticipate and maintain postpartum monitoring until blood pressure is normalized, or women referred or discharged to family physicians as appropriate. In particular, attention should be given to women who are obese, and or of higher maternal age.
UR - http://www.scopus.com/inward/record.url?scp=85115939244&partnerID=8YFLogxK
U2 - 10.5334/GH.854
DO - 10.5334/GH.854
M3 - Article
C2 - 34692386
AN - SCOPUS:85115939244
SN - 2211-8160
VL - 16
JO - Global Heart
JF - Global Heart
IS - 1
M1 - 62
ER -
