尼日利亚联邦首都地区初级保健中妊娠高血压女性的临床特征和治疗模式：尼日利亚高血压治疗项目的横断面研究结果。
Clinical characteristics and treatment patterns of pregnant women with hypertension in primary care in the Federal Capital Territory of Nigeria: cross-sectional results from the hypertension treatment in Nigeria Program.
机构信息
Washington University, 660 S Euclid Ave, Campus Box 6068, St Louis, MO, 63110, USA.
Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.
出版信息
BMC Pregnancy Childbirth. 2023 Jun 3;23(1):416. doi: 10.1186/s12884-023-05723-1.
BACKGROUND
Hypertensive disorders of pregnancy, including hypertension, are a leading cause of maternal mortality in Nigeria. However, there is a paucity of data on pregnant women with hypertension who receive care in primary health care facilities. This study presents the results from a cross-sectional analysis of pregnant women enrolled in the Hypertension Treatment in Nigeria Program which is aimed at integrating and strengthening hypertension care in primary health care centres.
METHODS
A descriptive analysis of the baseline results from the Hypertension Treatment in Nigeria Program was performed. Baseline blood pressures, treatment and control rates of pregnant women were analysed and compared to other adult women of reproductive age. A complete case analysis was performed, and a two-sided p value < 0.05 was considered statistically significant.
RESULTS
Between January 2020 to October 2022, 5972 women of reproductive age were enrolled in the 60 primary healthcare centres participating in the Hypertension Treatment in Nigeria Program and 112 (2%) were pregnant. Overall mean age (SD) was 39.6 years (6.3). Co-morbidities were rare in both groups, and blood pressures were similar amongst pregnant and non-pregnant women (overall mean (SD) first systolic and diastolic blood pressures were 157.4 (20.6)/100.7 (13.6) mm Hg and overall mean (SD) second systolic and diastolic blood pressures were 151.7 (20.1)/98.4 (13.5) mm Hg). However, compared to non-pregnant women, pregnant women had a higher rate of newly diagnosed hypertension (65.2% versus 54.4% p = 0.02) and lower baseline walk-in treatment (32.1% versus 42.1%, p = 0.03). The control rate was numerically lower among pregnant patients (6.3% versus 10.2%, p = 0.17), but was not statistically significant. Some pregnant patients (8.3%) were on medications contraindicated in pregnancy, and none of the pregnant women were on aspirin for primary prevention of preeclampsia.
CONCLUSIONS
These findings indicate significant gaps in care and important areas for future studies to improve the quality of care and outcomes for pregnant women with hypertension in Nigeria, a country with the highest burden of maternal mortality globally.
背景
妊娠高血压疾病（包括高血压）是导致尼日利亚产妇死亡的主要原因之一。然而，在初级保健设施中接受治疗的妊娠高血压患者的数据却很少。本研究报告了“尼日利亚高血压治疗项目”中登记的孕妇的横断面分析结果，该项目旨在整合和加强初级保健中心的高血压治疗。
方法
对“尼日利亚高血压治疗项目”的基线结果进行了描述性分析。分析了妊娠和非妊娠妇女的基线血压、治疗和控制率，并与其他育龄期妇女进行了比较。进行了完全病例分析，双侧 p 值<0.05 被认为具有统计学意义。
结果
2020 年 1 月至 2022 年 10 月期间，共有 5972 名育龄妇女参加了“尼日利亚高血压治疗项目”的 60 个初级医疗保健中心，其中 112 名（2%）为孕妇。两组的平均年龄（标准差）分别为 39.6 岁（6.3 岁）。两组的合并症均很少见，妊娠和非妊娠妇女的血压相似（总体平均（标准差）第一次收缩压和舒张压分别为 157.4（20.6）/100.7（13.6）mmHg 和总体平均（标准差）第二次收缩压和舒张压分别为 151.7（20.1）/98.4（13.5）mmHg）。然而，与非妊娠妇女相比，孕妇新诊断高血压的发生率更高（65.2% 比 54.4%，p=0.02），而初始治疗的比例较低（32.1% 比 42.1%，p=0.03）。孕妇的控制率略低（6.3% 比 10.2%，p=0.17），但无统计学意义。一些孕妇（8.3%）正在服用妊娠禁忌药物，没有孕妇服用阿司匹林进行子痫前期的一级预防。
结论
这些发现表明，在尼日利亚，妊娠高血压患者的护理存在显著差距，也是未来研究的重要领域，这对提高该国妊娠高血压患者的护理质量和结局具有重要意义，因为尼日利亚是全球孕产妇死亡率最高的国家。
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