A Community Based Survey of High- Risk Pregnancies and Determinants of Pre- Eclampsia and Gestational Hypertension in Ada-A District Ethiopia

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Addis Ababa University


A population-based cross sectional survey was conducted from April 1990 to March 1991, to measure the magnitude of high risk pregnancies, and to examine the determinant factors for pre-eclampsia and gestational hypertension, in Ada-a district. 13 urban kebeles and 13 rural villages were randomly chosen and a house to house survey was conducted based on a pre tested questionnaire and relevant measurements. Information was collected on demographic, socioeconomic, the exposure status for risk factors prior and during the current pregnancy, the usual dietary intake and the usual physical activities during the early months of the current pregnancy, and measurement findings for height, blood pressure and proteinuria. A total of 567 pregnant women were included in the study. Of the 567 pregnant women 28.6% were younger than 20 or older than 34 years. Early marriage below the age of 20 were reported by 85%. 21.7% and 22.2% were Nulliparous and multiparous women respectively. 39.2% were illiterate and 42.9% with a very low income. 14.6% gave a history of abortion, 13.1% of infant deaths, 6.3% of postpartum hemorrhage and 1.1% of antepartum hemorrhage. Abnormal height was recorded in 18.5%, Albuminuria in 11.5% and abnormal diastolic blood pressure in 12.2%, where 2.9% and 9.2% were classified as pre-eclamptic and gestational hypertensive women. 52.3% were not receiving antenatal care services in the district. It was found that pregnant women in the very low category of income had a reduced risk of pre-eclampsia (RR =0.3, 95% CI 0.06, 1.07). And Nulliparous women had a higher risk (RR =5.6, 95% CI 1.83, 15.92 ) . High energy expenditure was observed to be a risk factor for gestational hypertension (RR =5.3,95% CI 1.35 , 45.77). Among the studied pregnant women, those who had at least one of the risk factors were very high (85%) . Antenatal care services were not received by the majority of the pregnant women, especially in the rural area. Relatively young women, with a better education, a better income, in their first pregnancy were at high risk of pre-eclampsia and gestational hypertension. strenuous physical exertion and low dietary protein intake during the early months of pregnancy also increased the risk of both pre-eclampsia and gestational hypertension. A high dietary calcium intake during the early months of pregnancy increased the risk of pre-eclampsia but not gestational hypertension. The results from this study indicate to increase Family Planning services and appropriate training, and use of community health workers in Ada-a district.



Gestational Hypertension