339. Why are pregnant women not screened for Hypertensive disorders of pregnancy (HDP) in Kinshasa, Democratic Republic of the Congo?

Abstract

Introduction Screening for HDP during antenatal visit allows identification of high-risk women, and initiation of early preventive interventions to improve pregnancy outcomes. In Kinshasa however, the majority of pregnant women attending antenatal clinics are not screened for HDP. Objective The study aimed to identify factors associated with the lack of screening for HDP in antenatal clinics in Kinshasa. Methods A stratified two-stage cluster sampling design was applied in a facility-based cross sectional study to select 580 pregnant women in 58 clinics (30 primary, 26 secondary and 2 tertiary). Data were collected by observation during antenatal consultation, interviewing pregnant women and reviewing antenatal records. A pregnant woman was considered as not screened for HDP if she did not benefit for blood pressure measurement, proteinuria testing and assessment for at least one of clinical risk factors from the American College of Obstetricians and Gynecologists. To identify factors associated to the lack of screening for HDP, we carried out a multivariate logistic regression model using generalized estimating equation. Results Of 580 pregnant women included, 73% were not tested for proteinuria, 41% were not assessed for risk factors, and 7% did not have their blood pressure checked. In total, 74% of pregnant women were not screened for HDP. In the multivariate analysis, being nulliparous (AOR = 1.98; 95%CI, 1.19–3.29, p  Discussion The majority of pregnant women attending antenatal care in Kinshasa are not screened for HDP. There is a need of increasing awareness of health providers in the screening for HDP to improve pregnancy outcomes in Kinshasa.