Abstract
We sought to estimate the incidence and risk factors associated with development of pre-eclampsia (PET) in Jos, Nigeria. An open cohort study of singleton pregnant women attending the antenatal clinic of Jos University Teaching Hospital (JUTH), Nigeria between November 2010 and August 2011. Eligible healthy women at ≤ 20 weeks gestation were enrolled and followed up until delivery or development of pre-eclampsia. Baseline demographic characteristics including weight, height and body mass index (BMI) were collected at enrollment. Incidence, risk factors and hazard ratios for developing PET were estimated with corresponding 95% confidence intervals and p-values. All statistical analyses were done with STATA version 11, college station, Texas, USA. A total of 2416 pregnant women were screened for eligibility out of which 323 were eligible for inclusion. The incidence of PET was 87.9 per 1,000 pregnancies (8.8%). The significant risk factors for PET were previous history of PET (RR=5.1, 95% CI: 2.2-12.1) and BMI at booking ≥ 25 kg/m2 (RR=3.9, 95% CI: 1.5-10.0). The incidence of PET was relatively high in our cohort in Jos, Nigeria and a previous history of the disease and overweight or obese pregnant women have a significant hazard of developing the disease in the course of gestational follow up. Targeting women with these characteristics for early preventive intervention and close surveillance at the antenatal booking clinic may help in prevention of the disease and its complications.
Highlights
Hypertensive disorders in pregnancy affects up to 8% of pregnancies[1] and are among the leading causes of maternal and neonatal morbidity and mortality worldwide, African Health Sciences features of pre-eclampsia and addressing gaps in appropriate management of the condition during pregnancy[4]
The incidence of PET was relatively high in our cohort in Jos, Nigeria and a previous history of the disease and overweight or obese pregnant women have a significant hazard of developing the disease in the course of gestational follow up
Clinical risk prediction research on the development of pre-eclampsia have focused on nulliparous pregnant women and identified risk factors measured at 14-16 weeks gestation including maternal age, mean arterial blood pressure, body mass index, family history of preeclampsia, family history of coronary heart disease and maternal birth weight[9]
Summary
Hypertensive disorders in pregnancy affects up to 8% of pregnancies[1] and are among the leading causes of maternal and neonatal morbidity and mortality worldwide, African Health Sciences features of pre-eclampsia and addressing gaps in appropriate management of the condition during pregnancy[4]. Delays in diagnosis and access to effective treatment are leading factors responsible for high maternal and perinatal mortality from pre-eclampsia[7]. Studies have shown the significance of prediction, prevention, diagnosis and treatment among the evidence-based interventions for improving maternal and perinatal outcomes in pre-eclampsia and other hypertensive diseases during pregnancy[8]. Other previously documented risk factors include systolic blood pressure at entry and pre-pregnancy obesity[10]. Most of these studies were done in countries outside of Africa and the generalizability of these findings to women in Nigerian settings may be limited
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