Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Risk Factors for Hypertensive Disorders in Pregnancy: A Report from the Maroua Regional Hospital, Cameroon

Authors
Pierre Marie Tebeu 1
Pascal Foumane 2
Robinson Mbu 2
Gisèle Fosso 3
Paul Tjek Biyaga 4
Joseph Nelson Fomulu 4
1 Department of Obstetrics and Gynaecology, University Hospitals, Yaoundé, Cameroon; Ligue d’Initiative et de Recherche Active pour la Santé et l’Education de la Femme (LIRASEF), Yaoundé, Cameroon; Department of Obstetrics an
2 Department of Obstetrics and Gynaecology, University Hospitals, Yaoundé, Cameroon
3 Ligue d’Initiative et de Recherche Active pour la Santé et l’Education de la Femme (LIRASEF), Yaoundé, Cameroon
4 Department of Obstetrics and Gynaecology, Regional Hospital, Maroua, Cameroon
Abstract
Background: A recent study at the Maroua Provincial Hospital revealed that hypertension in pregnancy was the first cause of maternal death, representing 17.5% of the 63 maternal deaths recorded between 2003 and 2005. Knowing little about the causes, this study was to identify the possible risk factors for hypertensive disorders in pregnancy. Methods: This case-control study was-done at the Maroua Regional Hospital, Cameroon between June 2005 and May 2007. All the 152 deliveries complicated with hypertension were compared and analyzed with 414 pregnancies that were not complicated with the disease. Data analysis was performed using EPI Info 3.5.1. The differences were considered to be significant if the p-values were less than 0.05. Results: Using univariate analysis, several factors linked to hypertensive disorder in pregnancy were identified. They included early adolescence, nulliparity, illiteracy, lack of occupation and family history of hypertension. At multivariate analysis, the risk of having hypertension during pregnancy remained greater for illiterate women (OR: 1.6; 95%CI: 1.0-2.3), housewives (OR: 2.8; 95%CI: 1.1-6.9), nulliparae (OR: 2.8; 95%CI: 1.5-3.6), women with family histories of hypertension (OR: 3.6; 95%CI: 1.6-8.5) and women with histories of hypertension during pregnancy (OR: 7.0; 95%CI: 3.0-16.4). Conclusion: Risk factors for hypertensive diseases in pregnancy in Maroua, Cameroon seem to include early teenage status, illiteracy, housewife status, nulliparity and family or personal histories of hypertension. The knowledge about the aforesaid factors seems to lay the tracks for its prevention in Cameroon.
Keywords
Hypertension
Pregnancy
risk factor
  1. ACOG. ACOG technical bulletin. Hypertension in pregnancy. Number 219--January 1996 (replaces no. 91, February 1986). Committee on Technical Bulletins of the American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 1996;53(2): 175-83.
  2. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III LC, Wenstrom KD. Williams Obstetrics. 22th ed. USA: McGraw-Hill Companies Inc; 2005. Chapter 34, Hypertensive disorders in pregnancy; p. 426-50.
  3. McCaw Binns AM, MacGillivray I, Hawkins N, Golding J, Ashley DEC. International variation in the incidence of hypertension in pregnancy among primiparae: the Jamaican experience. West Indian Med J. 1997;46(Suppl 2):29.
  4. Schroeder BM; American College of Obstetricians and Gynecologists. ACOG practice bulletin on diagnosing and managing preeclampsia and eclampsia. American College of Obstetricians and Gynecologists. Am Fam Physician. 2002;66(2):330-1.
  5. Working Group on High Blood Pressure . Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183(1):S1-S22.
  6. Roberts CL, Algert CS, Morris JM, Ford JB, Henderson-Smart DJ. Hypertensive disorders in pregnancy: a population-based study. Med J Aust. 2005;182(7):332-5.
  7. Golding J. A randomised trial of low dose aspirin for primiparae in pregnancy. The Jamaica Low Dose Aspirin Study Group. Br J Obstet Gynaecol. 1998; 105(3):293-9.
  8. Levine RJ, Hauth JC, Curet LB, Sibai BM, Catalano PM, Morris CD, et al. Trial of calcium to prevent preeclampsia. N Engl J Med. 1997;337(2):69-76.
  9. Conde-Agudelo A, Belizán JM. Risk factors for preeclampsia in a large cohort of Latin American and Caribbean women. BJOG. 2000;107(1):75-83.
  10. Trogstad LI, Eskild A, Magnus P, Samuelsen SO, Nesheim BI. Changing paternity and time since last pregnancy; the impact on pre-eclampsia risk. A study of 547 238 women with and without previous pre-eclampsia. Int J Epidemiol. 2001;30 (6):1317-22.
  11. Shey Wiysonge CU, Ngu Blackett K, Mbuagbaw JN. Risk factors and complications of hypertension in Yaounde, Cameroon. Cardiovasc J S Afr. 2004; 15(5):215-9.
  12. Pridjian G, Puschett JB. Preeclampsia. Part 1: clinical and pathophysiologic considerations. Obstet Gynecol Surv. 2002;57(9):598-618.
  13. Leeners B, Rath W, Kuse S, Irawan C, Imthurn B, Neumaier-Wagner P. BMI: new aspects of a classical risk factor for hypertensive disorders in pregnancy. Clin Sci (Lond). 2006;111(1):81-6.
  14. Tebeu PM, Ngassa P, Kouam L, Major AL, Fomulu JN. Maternal mortality in Maroua Provincial Hospital, Cameroon (2003-2005). West Indian Med J. 2007;56(6):502-7.
  15. Chesley LC. History and epidemiology of preeclampsia-eclampsia. Clin Obstet Gynecol. 1984; 27(4):801-20.
  16. Saftlas AF, Olson DR, Franks AL, Atrash HK, Pokras R. Epidemiology of preeclampsia and eclampsia in the United States, 1979-1986. Am J Obstet Gynecol. 1990;163(2):460-5.
  17. Adeyinka DA, Oladimeji O, Adekanbi TI, Adeyinka FE, Falope Y, Aimakhu C. Outcome of adolescent pregnancies in southwestern Nigeria: a case control study. J Matern Fetal Neonatal Med. 2010; 23(8):785-9.
  18. Usta IM, Zoorob D, Abu-Musa A, Naassan G, Nassar AH. Obstetric outcome of teenage pregnancies compared with adult pregnancies. Acta Obstet Gynecol Scand. 2008;87(2):178-83.
  19. Suzuki S, Igarashi M. Risk factors for preeclampsia in Japanese twin pregnancies: comparison with those in singleton pregnancies. Arch Gynecol Obstet. 2009;280(3):389-93.
  20. Assis TR, Viana FP, Rassi S. Study on the major maternal risk factors in hypertensive syndromes. Arq Bras Cardiol. 2008;91(1):11-7.
  21. Poon LC, Kametas NA, Chelemen T, Leal A, Nicolaides KH. Maternal risk factors for hypertensive disorders in pregnancy: a multivariate approach. J Hum Hypertens. 2010;24(2):104-10.
  22. Jacobs DJ, Vreeburg SA, Dekker GA, Heard AR, Priest KR, Chan A. Risk factors for hypertension during pregnancy in South Australia. Aust N Z J Obstet Gynaecol. 2003;43(6):421-8.
  23. Kimbally KG, Barassoumbi H, Buambo SF, Gombet T, Kibeke P, Monabeka HG, et al. [Arterial hypertension: epidemiological aspects and risk factors on pregnant and delivered woman]. Dakar Med. 2007;52(2):148-52. French.
  24. Li DK, Wi S. Changing paternity and the risk of preeclampsia/eclampsia in the subsequent pregnancy. Am J Epidemiol. 2000;151(1):57-62.
  25. Trupin LS, Simon LP, Eskenazi B. Change in paternity: a risk factor for preeclampsia in multiparas. Epidemiology. 1996;7(3):240-4.
  26. Silva LM, Coolman M, Steegers EA, Jaddoe VW, Moll HA, Hofman A, et al. Low socioeconomic status is a risk factor for preeclampsia: the Generation R Study. J Hypertens. 2008;26(6): 1200-8.
  27. Silva L, Coolman M, Steegers E, Jaddoe V, Moll H, Hofman A, et al. Maternal educational level and risk of gestational hypertension: the Generation R Study. J Hum Hypertens. 2008;22(7):483-92.
  28. Mittendorf R, Lain KY, Williams MA, Walker CK. Preeclampsia. A nested, case-control study of risk factors and their interactions. J Reprod Med. 1996; 41(7):491-6.
  29. Najman JM, Morrison J, Williams GM, Andersen MJ, Keeping JD. The employment of mothers and the outcomes of their pregnancies: an Australian study. Public Health. 1989;103(3):189-98.
  30. Jansen PW, Tiemeier H, Verhulst FC, Burdorf A, Jaddoe VW, Hofman A, et al. Employment status and the risk of pregnancy complications: the Generation R Study. Occup Environ Med. 2010;67(6): 387-94.
  31. El-Gilany AH, El-Wehady A, El-Hawary A. Maternal employment and maternity care in Al-Hassa, Saudi Arabia. Eur J Contracept Reprod Health Care. 2008;13(3):304-12.
  32. Bao Y, Hu Y, Fu S, Zhang J, Zhang F, Wang X. [Studies on relationship between occupation and pregnancy outcome]. Zhonghua Yu Fang Yi Xue Za Zhi. 1999;33(1):30-3. Chinese.
  33. Craici I, Wagner S, Garovic VD. Preeclampsia and future cardiovascular risk: formal risk factor or failed stress test? Ther Adv Cardiovasc Dis. 2008; 2(4):249-59.
  34. Luealon P, Phupong V. Risk factors of preeclampsia in Thai women. J Med Assoc Thai. 2010;93(6): 661-6.
  35. Hjartardottir S, Leifsson BG, Geirsson RT, Steinthorsdottir V. Paternity change and the recurrence risk in familial hypertensive disorder in pregnancy. Hypertens Pregnancy. 2004;23(2):219-25.
Journal of Reproduction & Infertility
Volume 12, Issue 3
Summer 2011
Pages 227-234