Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study
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 m...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ubiquity Press
2021-09-01
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| Series: | Global Heart |
| Subjects: | |
| Online Access: | https://globalheartjournal.com/articles/854 |
| _version_ | 1819152586179084288 |
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| author | Salisu M. Ishaku Tukur Jamilu Agbo P. Innocent Kayode A. Gbenga Dattijo Lamaran Oyeneyin Lawal Charlotte E. Warren Owa O. Olorunfemi Hanifah D. Abubakar Tunau Karima Odusolu O. Patience Abdulkarim Musa Onyebuchi K. Azubuike Aminu M. Baffah Arie Franx Diederick E. Grobbee Joyce L. Browne |
| author_facet | Salisu M. Ishaku Tukur Jamilu Agbo P. Innocent Kayode A. Gbenga Dattijo Lamaran Oyeneyin Lawal Charlotte E. Warren Owa O. Olorunfemi Hanifah D. Abubakar Tunau Karima Odusolu O. Patience Abdulkarim Musa Onyebuchi K. Azubuike Aminu M. Baffah Arie Franx Diederick E. Grobbee Joyce L. Browne |
| author_sort | Salisu M. Ishaku |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T14:51:39Z |
| format | Article |
| id | doaj.art-f6631d8379394251b23277e4f1c7fd6a |
| institution | Directory Open Access Journal |
| issn | 2211-8179 |
| language | English |
| last_indexed | 2024-12-22T14:51:39Z |
| publishDate | 2021-09-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Global Heart |
| spelling | doaj.art-f6631d8379394251b23277e4f1c7fd6a2022-12-21T18:22:19ZengUbiquity PressGlobal Heart2211-81792021-09-0116110.5334/gh.854877Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort StudySalisu M. Ishaku0Tukur Jamilu1Agbo P. Innocent2Kayode A. Gbenga3Dattijo Lamaran4Oyeneyin Lawal5Charlotte E. Warren6Owa O. Olorunfemi7Hanifah D. Abubakar8Tunau Karima9Odusolu O. Patience10Abdulkarim Musa11Onyebuchi K. Azubuike12Aminu M. Baffah13Arie Franx14Diederick E. Grobbee15Joyce L. Browne16Population Council Nigeria, NG; Julius Global Health, Julius Center for Health Science and Primary Care, UMC Utrecht, Utrecht UniversityBayero University/Aminu Kano Teaching Hospital Kano, Kano StatePopulation Council NigeriaJulius Global Health, Julius Center for Health Science and Primary Care, UMC Utrecht, Utrecht University, NL; Institute of Human Virology, AbujaAbubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi StateUniversity of Medical Sciences Teaching Hospital, Ondo, Ondo StatePopulation Council-Washington DCMother and Child Hospital, AkureMuhammad Abdullahi Wase Teaching Hospital, Kano, Kano StateUsman DanFodio University Teaching hospital, Sokoto, Sokoto StateUniversity of Calabar Teaching Hospital, Calabar, Cross River StateFederal Medical Center, Lokoja, Kogi StateFederal Teaching Hospital, Abakaliki, Ebonyi StateAbubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi StateErasmus Medical Center, University Medical Center RotterdamJulius Global Health, Julius Center for Health Science and Primary Care, UMC Utrecht, Utrecht UniversityJulius Global Health, Julius Center for Health Science and Primary Care, UMC Utrecht, Utrecht UniversityBackground: 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.https://globalheartjournal.com/articles/854hypertensive disorder in pregnancypersistent hypertensionnigeria |
| spellingShingle | Salisu M. Ishaku Tukur Jamilu Agbo P. Innocent Kayode A. Gbenga Dattijo Lamaran Oyeneyin Lawal Charlotte E. Warren Owa O. Olorunfemi Hanifah D. Abubakar Tunau Karima Odusolu O. Patience Abdulkarim Musa Onyebuchi K. Azubuike Aminu M. Baffah Arie Franx Diederick E. Grobbee Joyce L. Browne Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study Global Heart hypertensive disorder in pregnancy persistent hypertension nigeria |
| title | Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study |
| title_full | Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study |
| title_fullStr | Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study |
| title_full_unstemmed | Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study |
| title_short | Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study |
| title_sort | persistent hypertension up to one year postpartum among women with hypertensive disorders in pregnancy in a low resource setting a prospective cohort study |
| topic | hypertensive disorder in pregnancy persistent hypertension nigeria |
| url | https://globalheartjournal.com/articles/854 |
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