19. The prevalence of chronic hypertension in pregnant women: A systematic review and meta-analysis

Abstract

Introduction Within the construct of Sustainable Development Goal (SDG) target 3.1, improving the measurement of maternal health will be key to addressing negative maternal outcomes. As such there has been a shift in focus from maternal mortality to morbidity, and in particular, pre-existing maternal conditions, such as chronic hypertension. This is associated with a number of poor maternal and perinatal outcomes, but the global prevalence of chronic hypertension among pregnant women is currently unknown. Objective To determine the global prevalence and regional distribution of chronic hypertension in pregnant women Methods We completed a comprehensive search using several electronic data bases as well as a grey literature search using Google. Observational studies from 1990–2015 were included regardless of language. To obtain a pooled estimate of the prevalence of chronic hypertension in pregnancy, a random effects model was used. Potential factors that might affect the prevalence of chronic hypertension were defined a priori (study type, quality, period and country income level) and stratified analyses were conducted in STATA 14.1. Results Of 40 relevant studies, 22 were population-based and 30 were from high-income countries; one study was from a low-income country (Togo) and 9 from middle-income countries. The overall prevalence of chronic hypertension was 1.6%, 95% CI 0.12–0.20, without a difference between hospital-based and population based studies. Chronic hypertension prevalence was lower in middle-income (0.6%, 95% CI 0.004–0.009) than high-income countries (1.7%, 95% CI 0.013–0.022) (p Discussion This is the first study to provide a global estimate of the prevalence of chronic hypertension in pregnant women. However, there are several limitations including poor quality studies, predominance of studies from high-income countries and variable definitions of chronic hypertension.