School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
PLoS One. 2019 Oct 4;14(10):e0223478. doi: 10.1371/journal.pone.0223478. eCollection 2019.
Data pertaining to maternal and perinatal outcomes associated with the complete spectrum of hypertensive disorders in pregnancy (HDPs) is sparse in low resource settings. This study aimed to determine adverse maternal and perinatal outcomes among women admitted with HDPs in a tertiary hospital in Ghana, and directly compare these outcomes among women with pre-eclampsia/eclampsia and those with chronic/gestational hypertension.
An analytical cross-sectional study was conducted among women who were admitted with HDPs to Komfo Anokye Teaching Hospital from July 1, 2014 to September 30, 2014. Data was collected on their socio-demographic and reproductive characteristics using a pretested structured questionnaire and review of their antenatal records. Crude and adjusted relative risks (RRs), with 95% confidence intervals (CIs), associated with adverse maternal and perinatal outcomes were compared using multivariable binomial regression. P ≤0.05 was considered statistically significant.
A total of 451 women with HDPs were studied: 5.3%, 32.4%, 48.8% and 13.5% had chronic hypertension, gestational hypertension, pre-eclampsia and eclampsia respectively. Over 80% were either referrals or "self-referred" from other facilities. Overall, 87% had adverse maternal or perinatal outcomes. Women with pre-eclampsia/eclampsia were at increased risks of caesarean section (adjusted RR, 1.37; 95% CI, 1.01-1.87), preterm delivery at <34 weeks' gestation (adjusted RR, 2.74; 95% CI, 1.40-5.36) and preterm delivery at <37 weeks' gestation (adjusted RR, 1.89; 95% CI, 1.25-2.85), compared to women with chronic/gestational hypertension.
Women with pre-eclampsia/eclampsia were at higher risk of adverse pregnancy outcome compared to those with chronic/gestational hypertension. Strategies for prevention and management of pre-eclampsia/eclampsia to improve pregnancy outcomes are required in this major maternity care centre.
在资源匮乏的环境中，有关妊娠期间各种高血压疾病（HDP）相关母婴围生期结局的数据很少。本研究旨在确定加纳一家三级医院中因 HDP 住院的女性的不良母婴围生期结局，并直接比较子痫前期/子痫和慢性/妊娠期高血压女性的这些结局。
2014 年 7 月 1 日至 9 月 30 日，对因 HDP 入住 Komfo Anokye 教学医院的女性进行了一项分析性横断面研究。使用预测试的结构化问卷和产前记录回顾收集其社会人口统计学和生殖特征数据。使用多变量二项式回归比较与不良母婴围生期结局相关的粗和调整相对风险（RR）及其 95%置信区间（CI）。P≤0.05 被认为具有统计学意义。
共研究了 451 名 HDP 女性：5.3%、32.4%、48.8%和 13.5%分别患有慢性高血压、妊娠期高血压、子痫前期和子痫。超过 80%的人是从其他医疗机构转诊或“自行转诊”。总体而言，87%的人母婴围生期结局不良。与患有慢性/妊娠期高血压的女性相比，患有子痫前期/子痫的女性剖宫产（调整 RR，1.37；95%CI，1.01-1.87）、<34 周早产（调整 RR，2.74；95%CI，1.40-5.36）和<37 周早产（调整 RR，1.89；95%CI，1.25-2.85）的风险增加。
与患有慢性/妊娠期高血压的女性相比，子痫前期/子痫女性发生不良妊娠结局的风险更高。在这家主要的产科中心，需要制定预防和管理子痫前期/子痫的策略，以改善妊娠结局。
