College of Health Sciences, Department of Obstetrics and Gynecology, Mekelle University, Ethiopia Witten Street, Mekelle, Ethiopia.
College of Health Sciences, Department of Health Systems, Mekelle University, Mekelle, Ethiopia.
BMC Pregnancy Childbirth. 2021 Mar 30;21(1):261. doi: 10.1186/s12884-021-03712-w.
Preeclampsia (PE) is one of the main causes of medical complication of pregnancy and is the main cause of perinatal mortality and morbidity. It is one of the top causes of maternal mortality in Ethiopia. Also known as transient hypertension, gestational hypertension (GH) is increased blood pressure during pregnancy without proteinuria, which is expected to return to normal by the 12th-week postpartum visit. PE is GH with proteinuria and /or other systemic manifestations. Evidence from high income countries show that GH significantly progresses towards PE. To our knowledge, this is the first study on the progression of GH towards PE in an African setting. The objective of this study is, therefore, to assess the incidence of GH, progression towards PE and factors associated with progression in Ethiopia.
This is a prospective cohort study conducted at Ayder Comprehensive Specialized Hospital (ACSH) and Mekelle General Hospital (MGH), the largest referral centers in Northern Ethiopia. Two hundred and forty women with GH were enrolled and followed up until delivery. Clinical and laboratory data at initial presentation and at follow-up were compared among women who progressed towards PE and who remained with the diagnosis of GH. Logistic regression analysis was employed to model the combined effects of the clinical and laboratory data as significant predictors of progression from GH to PE.
The incidence of GH in this study was 6 % (4.9-8.5). The rate of progression was 17.1 % (13.4-23.8). Previous history of GH, anemia during pregnancy, previous second-trimester spontaneous abortion were significant predictors of progression.
There is a high rate of progression of GH towards PE. In a resource-limited setting where predictive and diagnostic tools are scarce, clinical profile of women should be taken into consideration for prediction and diagnosis of PE.
子痫前期（PE）是妊娠医学并发症的主要原因之一，也是围产期死亡率和发病率的主要原因。它也是埃塞俄比亚孕产妇死亡的主要原因之一。妊娠期高血压（GH）又称短暂性高血压，是指妊娠期间血压升高而无蛋白尿，预计在产后 12 周就诊时会恢复正常。PE 是 GH 伴有蛋白尿和/或其他全身表现。来自高收入国家的证据表明，GH 显著向 PE 进展。据我们所知，这是在非洲背景下首次研究 GH 向 PE 的进展情况。因此，本研究的目的是评估 GH 的发生率、向 PE 的进展以及与进展相关的因素在埃塞俄比亚的情况。
这是一项在埃塞俄比亚北部最大的转诊中心阿德尔综合专科医院（ACSH）和梅克尔综合医院（MGH）进行的前瞻性队列研究。纳入了 240 名 GH 患者，并在分娩前进行随访。比较了向 PE 进展的患者和仍被诊断为 GH 的患者在初始就诊和随访时的临床和实验室数据。采用逻辑回归分析对临床和实验室数据的综合效应进行建模，以评估其作为向 PE 进展的显著预测因子的能力。
本研究中 GH 的发生率为 6%（4.9-8.5）。进展率为 17.1%（13.4-23.8）。既往 GH 病史、妊娠期间贫血、既往孕中期自然流产是进展的显著预测因子。
GH 向 PE 进展的发生率较高。在资源有限的情况下，预测和诊断工具稀缺，应考虑女性的临床特征来预测和诊断 PE。
