Maternal and Perinatal Outcomes Among Pregnant Women with Hypertensive Disorders in the Volta Region

Abstract

Hypertension, the commonest medical condition in pregnancy is a major cause of maternal and perinatal morbidity and mortality. It accounts for about 10% of pregnancy-related complications. Although complications of hypertensive disorders in pregnancy (HDP) could be reduced by 70% with effective management, resources for their effective management in most district hospitals in the Volta Region are lacking. This study aimed to assess maternal and perinatal outcomes among pregnant women with hypertensive disorders in the Volta Region of Ghana. This analytical cross-sectional study design using a simple random sampling technique to choose hospitals and a purposive sampling technique to choose patient collected data on the socio-demographic and maternal characteristics, maternal and perinatal outcomes using a pretested data extraction form from antenatal, delivery, and postnatal record books of 130 women with HDP. Crude and adjusted relative risk (RR) using multivariable binomial regression at P< 0.05 is considered significant when adverse maternal and perinatal outcomes were compared. A majority (63.1%) of the respondents were Christians who belong to a low-risk obstetric age group of 20- 35 years (66.2%), are medium to high-income earners (65.4%) and have had at least 9 years of formal education (90%). The study observed a high prevalence of obstetric complications such as meconium-stained amniotic fluid (24.62%), premature rupture of membrane (23.85%), haemorrhage (69.2%), and placenta abruption (13.08%). Adverse perinatal outcomes: APGAR score less than 7 at minute 1 (66.92%) and 5(13.08%), low birth weight (33.08%), intensive care unit admission requirement (25.38%), congenital abnormalities (10%), and stillbirth (8.46%) were observed. Maternal ethnicity, premature rupture of membrane, haemorrhage, placenta abruption and mode of delivery are risk factors for APGAR score less than 7 at minute 1 whereas haemorrhage, being single, meconium-stained amniotic fluid, and placenta abruption are risk factors for APGAR score less than 7 at minute 5. Low income is a risk factor for congenital abnormalities. Maternal educational level is a risk factor for placenta abruption. Maternal age >35 years is a risk factor for premature rupture of membrane. Premature rupture of membrane, placenta abruption and spontaneous vaginal delivery are risk factors for small for gestational age. Premature rupture of membrane is a risk factor for neonatal intensive care unit admission and meconium-stained amniotic fluid is a risk factor for still birth. The need for improved maternal and perinatal care services for women with HDP cannot be overemphasized for better obstetric outcomes.