Abstract：
OBJECTIVE: Determine prevalence, risk factors and outcomes of hypertensive disorders in pregnancy (HDP).
METHODS: Cross-sectional analysis of data captured in the Maternal and Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) between September 2019 and August 2020.
METHODS: Fifty-four referral level facilities in Nigeria.
METHODS: Women whose pregnancy ended (irrespective of the location or duration of pregnancy) or who were admitted within 42 days of delivery.
METHODS: Descriptive statistics and multilevel mixed-effects logistic regression models.
METHODS: Prevalence of HDP, sociodemographic and clinical factors associated with HDP and perinatal outcomes.
RESULTS: Among the 71 758 women 6.4% had HDP and gestational hypertension accounted for 49.8%. Preeclampsia and eclampsia were observed in 9.5% and 7.0% of all pregnancies, respectively. The predictors of HDP were age over 35 years (OR1.96, 95% CI 1.82-2.12; p < 0.001), lack of formal educational (OR 1.18, 95% CI 1.06-1.32; p = 0.002), primary level of education (OR 1.20, 95% CI 1.03-1.4; p < 0.002), nulliparity (OR 1.21, 95% CI 1.12-1.31; p < 0.001), grand-multiparity (OR 1.36, 95%CI 1.21-1.52; p < 0.001), previous caesarean section (OR 1.26, 95%CI 1.15-1.38; p < 0.001) and previous miscarriage (OR 1.22, 95% CI 1.13-1.31; p < 0.001). Overall 3.7% of the patients with HDP died, with eclampsia having the highest case fatality rate of 27.9%. Stillbirth occurred in 11.9% of pregnancies with hypertensive disorders.
CONCLUSIONS: Hypertensive disorders in pregnancy are not uncommon in Nigeria. They are associated with adverse outcomes with over one-quarter of women with eclampsia dying. The main predictors include older age, poor education, extremes of parity and previous CS or miscarriage. Maternal and perinatal outcomes are poor with about a quarter developing complications and about 1 in 10 having stillbirths.
METHODS: Cross-sectional analysis of data captured in the Maternal and Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) between September 2019 and August 2020.
METHODS: Fifty-four referral level facilities in Nigeria.
METHODS: Women whose pregnancy ended (irrespective of the location or duration of pregnancy) or who were admitted within 42 days of delivery.
METHODS: Descriptive statistics and multilevel mixed-effects logistic regression models.
METHODS: Prevalence of HDP, sociodemographic and clinical factors associated with HDP and perinatal outcomes.
RESULTS: Among the 71 758 women 6.4% had HDP and gestational hypertension accounted for 49.8%. Preeclampsia and eclampsia were observed in 9.5% and 7.0% of all pregnancies, respectively. The predictors of HDP were age over 35 years (OR1.96, 95% CI 1.82-2.12; p < 0.001), lack of formal educational (OR 1.18, 95% CI 1.06-1.32; p = 0.002), primary level of education (OR 1.20, 95% CI 1.03-1.4; p < 0.002), nulliparity (OR 1.21, 95% CI 1.12-1.31; p < 0.001), grand-multiparity (OR 1.36, 95%CI 1.21-1.52; p < 0.001), previous caesarean section (OR 1.26, 95%CI 1.15-1.38; p < 0.001) and previous miscarriage (OR 1.22, 95% CI 1.13-1.31; p < 0.001). Overall 3.7% of the patients with HDP died, with eclampsia having the highest case fatality rate of 27.9%. Stillbirth occurred in 11.9% of pregnancies with hypertensive disorders.
CONCLUSIONS: Hypertensive disorders in pregnancy are not uncommon in Nigeria. They are associated with adverse outcomes with over one-quarter of women with eclampsia dying. The main predictors include older age, poor education, extremes of parity and previous CS or miscarriage. Maternal and perinatal outcomes are poor with about a quarter developing complications and about 1 in 10 having stillbirths.
摘要：
目标：确定患病率，妊娠期高血压疾病（HDP）的危险因素和结局。
方法：对孕产妇和围产期质量数据库中捕获的数据进行横断面分析，2019年9月至2020年8月期间的公平和尊严(MPD-4-QED)。
方法：尼日利亚有54个转诊级别的设施。
方法：妊娠结束（与妊娠地点或妊娠时间无关）或分娩后42天内入院的妇女。
方法：描述性统计和多水平混合效应逻辑回归模型。
方法：HDP的患病率，与HDP和围产期结局相关的社会人口统计学和临床因素。
结果：在71758名妇女中，HDP占6.4％，妊娠期高血压占49.8％。在所有妊娠的9.5%和7.0%中观察到先兆子痫和子痫。分别。HDP的预测因素是年龄超过35岁（OR1.96，95％CI1.82-2.12；p<0.001），缺乏正规教育(OR1.18，95%CI1.06-1.32；p=0.002)，小学教育水平(OR1.20，95%CI1.03-1.4；p<0.002)，无效性(OR1.21，95%CI1.12-1.31；p<0.001)，大多重奇偶校验(OR1.36，95CI1.21-1.52；p<0.001)，既往剖腹产(OR1.26,95CI1.15-1.38;p<0.001)和既往流产(OR1.22,95%CI1.13-1.31;p<0.001)。总共有3.7%的HDP患者死亡，子痫的病死率最高，为27.9%。11.9%的妊娠合并高血压疾病者发生死胎。
结论：妊娠期高血压疾病在尼日利亚并不少见。它们与超过四分之一的子痫妇女死亡的不良后果有关。主要预测因素包括年龄，教育差,奇偶校验和先前CS或流产的极端。孕产妇和围产期结局不佳，约有四分之一的人出现并发症，约十分之一的人出现死胎。
方法：对孕产妇和围产期质量数据库中捕获的数据进行横断面分析，2019年9月至2020年8月期间的公平和尊严(MPD-4-QED)。
方法：尼日利亚有54个转诊级别的设施。
方法：妊娠结束（与妊娠地点或妊娠时间无关）或分娩后42天内入院的妇女。
方法：描述性统计和多水平混合效应逻辑回归模型。
方法：HDP的患病率，与HDP和围产期结局相关的社会人口统计学和临床因素。
结果：在71758名妇女中，HDP占6.4％，妊娠期高血压占49.8％。在所有妊娠的9.5%和7.0%中观察到先兆子痫和子痫。分别。HDP的预测因素是年龄超过35岁（OR1.96，95％CI1.82-2.12；p<0.001），缺乏正规教育(OR1.18，95%CI1.06-1.32；p=0.002)，小学教育水平(OR1.20，95%CI1.03-1.4；p<0.002)，无效性(OR1.21，95%CI1.12-1.31；p<0.001)，大多重奇偶校验(OR1.36，95CI1.21-1.52；p<0.001)，既往剖腹产(OR1.26,95CI1.15-1.38;p<0.001)和既往流产(OR1.22,95%CI1.13-1.31;p<0.001)。总共有3.7%的HDP患者死亡，子痫的病死率最高，为27.9%。11.9%的妊娠合并高血压疾病者发生死胎。
结论：妊娠期高血压疾病在尼日利亚并不少见。它们与超过四分之一的子痫妇女死亡的不良后果有关。主要预测因素包括年龄，教育差,奇偶校验和先前CS或流产的极端。孕产妇和围产期结局不佳，约有四分之一的人出现并发症，约十分之一的人出现死胎。
