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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Date
1991-03
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Addis Ababa University
Abstract
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.
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Keywords
Gestational Hypertension