256. The incidence of pregnancy hypertension in the Community Level Interventions for Pre-eclampsia (CLIP) trials – Population-level data from Mozambique, Nigeria, India and Pakistan

Abstract

Background Most estimates of pregnancy hypertension incidence in less-developed countries are from hospital-based cross-sectional surveys and are likely too high. Objective We aimed to estimate population-based rates in intervention clusters of the CLIP cluster trials (NCT01911494). Methods In study regions, all pregnant women were eligible and identified in their homes or local primary health centres (2013–17). In intervention clusters, trained community health care workers (CHWs) provided supplementary hypertension-oriented care that included standardised blood pressure (BP) measurement using the validated CRADLE device. Hypertension was BP ⩾ 140/90 mmHg (⩾2 measurements). Based on gestational age at presentation, hypertension was chronic ( 0.05 significant). Results Most women (N = 43,189 in 27 intervention clusters) received at least one CHW-measured BP and were delivered by trial end. Pregnancy hypertension incidence was significantly lower in Pakistan (9.3%) than India (10.4%), Mozambique (11.0%), or Nigeria (10.1%) (p Discussion Pregnancy hypertension incidence and type are similar in less- and more-developed settings. Most women present with gestational hypertension which is amenable to surveillance and timed delivery aimed at decreasing mortality and morbidity.