%0 Journal Article
%T Predictors, prevalence and outcome of hypertensive disorders in pregnancy in Nigerian tertiary health facilities: A secondary analysis of the Maternal and Perinatal Database for Quality, Equity and Dignity Programme.
%A Abdurrahman A
%A Adamu AN
%A Ashimi A
%A Adekunle OO
%A Bature SB
%A Aliyu LD
%A Akeem O
%A Abdullahi H
%A Lavin T
%A Daneji S
%A Musa B
%A Muazu Z
%A Tukur J
%A Galadanci HS
%J BJOG
%V 0
%N 0
%D 2024 Jul 3
%M 38960882
%F 7.331
%R 10.1111/1471-0528.17902
%X <B>OBJECTIVE: </B>Determine prevalence, risk factors and outcomes of hypertensive disorders in pregnancy (HDP).<BR><B>METHODS: </B>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.<BR><B>METHODS: </B>Fifty-four referral level facilities in Nigeria.<BR><B>METHODS: </B>Women whose pregnancy ended (irrespective of the location or duration of pregnancy) or who were admitted within 42 days of delivery.<BR><B>METHODS: </B>Descriptive statistics and multilevel mixed-effects logistic regression models.<BR><B>METHODS: </B>Prevalence of HDP, sociodemographic and clinical factors associated with HDP and perinatal outcomes.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.