Mwanri Akwilina W, Kinabo Joyce L, Ramaiya Kaushik, Feskens Edith J M
aSokoine University of Agriculture, Department of Food Science and Technology, Chuo Kikuu, Morogoro, Tanzania bWageningen University, Wageningen, The Netherlands cShree HinduMandal Hospital, Dar es Salaam, Tanzania.
J Hypertens. 2015 May;33(5):940-7. doi: 10.1097/HJH.0000000000000501.
Hypertension during pregnancy (HDP) is one of the leading causes of maternal and perinatal mortality worldwide. This study examined prevalence and potential risk factors for HDP among pregnant women in Tanzania.
We examined 910 pregnant women, aged at least 20 years, mean gestational age 27 weeks, from rural (n = 301) and urban (n = 609) areas, during their usual antenatal clinic visits. Hypertension was defined as clinic SBP at least 140 mmHg or DBP at least 90 mmHg. Dietary assessment included dietary diversity score using 16 food groups. Multiple logistic regression analysis was used to assess the independent association of risk factors associated with prevalence of hypertension.
A total of 62 women (6.9%) had HDP, prevalence being higher in urban (8.1%) compared to rural area (4.4%). For the urban area, mother's age [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.03-1.20], gestational age (OR 1.10, 95% CI 1.02-1.20), mid-upper arm circumference (OR 1.13, 95% CI 1.01-1.23), dietary diversity score (OR 1.31, 95% CI 1.20-1.60) and being HIV-positive (OR 2.40, 95% CI 1.10-5.18) were independently associated with HDP. When adjusted for proteinuria, associations with HIV status and mid-upper arm circumference weakened. In the rural area, HDP risk increased with age and gestational age.
Prevalence of HDP was higher in urban compared to rural area, which points at high risk for preterm delivery, low birth weight and future cardiovascular diseases. The observed risk factors identify risk groups to be screened and targeted for prevention. The role of HIV status needs to be further explored.
妊娠期高血压(HDP)是全球孕产妇和围产期死亡的主要原因之一。本研究调查了坦桑尼亚孕妇中HDP的患病率及潜在风险因素。
我们在常规产前检查期间,对910名年龄至少20岁、平均孕周27周、来自农村(n = 301)和城市(n = 609)地区的孕妇进行了检查。高血压定义为诊所收缩压至少140 mmHg或舒张压至少90 mmHg。饮食评估包括使用16种食物组的饮食多样性评分。采用多因素logistic回归分析评估与高血压患病率相关的危险因素的独立关联。
共有62名女性(6.9%)患有HDP,城市地区(8.1%)的患病率高于农村地区(4.4%)。在城市地区,母亲年龄[比值比(OR)1.10,95%置信区间(CI)1.03 - 1.20]、孕周(OR 1.10,95% CI 1.02 - 1.20)、上臂中段周长(OR 1.13,95% CI 1.01 - 1.23)、饮食多样性评分(OR 1.31,95% CI 1.20 - 1.60)以及HIV阳性(OR 2.40,95% CI 1.10 - 5.18)与HDP独立相关。调整蛋白尿后,与HIV状态和上臂中段周长的关联减弱。在农村地区,HDP风险随年龄和孕周增加。
城市地区HDP的患病率高于农村地区,这表明早产、低出生体重和未来心血管疾病的风险较高。观察到的风险因素确定了需要筛查和预防的风险群体。HIV状态的作用需要进一步探索。