CC BY 4.0 · Libyan International Medical University Journal 2024; 09(01): 009-014
DOI: 10.1055/s-0044-1779305
Original Article

A Cross-Sectional Study about Demographic and Medical Characteristics of Hypertensive Pregnant Women in Two Secondary Healthcare Facilities, in Ilorin, Nigeria

Assessment of Medications Used in the Management of Hypertension in Pregnancy in Two Secondary Healthcare Facilities, Ilorin
1   Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, University of Ilorin, Ilorin, Nigeria
,
O. O. Olatunde
1   Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, University of Ilorin, Ilorin, Nigeria
,
2   Department of Obstetrics and Gynecology, General Hospital Ilorin, Ilorin, Nigeria
,
S. I. Bello
1   Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, University of Ilorin, Ilorin, Nigeria
,
Qadri Olajide
1   Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, University of Ilorin, Ilorin, Nigeria
› Author Affiliations
Funding None declared.


Abstract

Background Hypertension is one of the major causes of related maternal deaths worldwide and it is one of the most common medical disorders encountered during pregnancy.

Aim This study aimed at assessing the demographic and medical characteristics of hypertensive pregnant women in two secondary healthcare facilities, in Ilorin, Nigeria

Method This was a cross-sectional study among 104 pregnant women with hypertension attending the outpatient department of General Hospital and Civil Service Clinic, Ilorin between March and May 2021. A validated self-administered questionnaire was used to obtain information on sociodemographics. Data on the medical characteristics of the respondents and their medications were extracted from the respondent's medical files. Ethical approval was obtained from the Ministry of Health and General Hospital, Ilorin. For statistical analysis for categorical measurements, the frequencies and percentages were computed.

Results Seventy-five percent of the correspondents were below 36 years old, 97% were married, 79% had tertiary education, and 74% were above 24 weeks of gestation. About 68% of the correspondents had blood pressure more than or equal to 140/90 and 10% had blood pressure more than 160 mm Hg systolic or more than 100 mm Hg diastolic. About 78.8% of the correspondents had a family history of hypertension, 13.5% had a family history of diabetes mellitus, and 22.1% had a family history of obesity. About 27.9% had pre-existing hypertension, 61.5% developed hypertension before the end of 20 weeks of gestation, and 10.6% developed hypertension after 20 weeks of gestation. About 24% had their antihypertensive medication changed during pregnancy, 38.5% were treated with methyldopa, 31.7% with nifedipine, and 27% with nifedipine and methyldopa. Majority (83.6%) of the respondents were not adherent to their medications.

Conclusion Two-third of the patients had poor blood pressure control irrespective of the fact that all were under drug therapy. Family history and large body mass index are the main risk factors for the development of hypertension during pregnancy. Noncompliance may play a significant role in no drug response.



Publication History

Article published online:
09 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 ACOG Committee on Practice Bulletins. ACOG Practice Bulletin. Chronic hypertension in pregnancy. Obstet Gynecol 2001; 98 (01) 177-185
  • 2 Magee LA, Sharma S, Nathan HL. et al; CLIP Study Group. The incidence of pregnancy hypertension in India, Pakistan, Mozambique, and Nigeria: a prospective population-level analysis. PLoS Med 2019; 16 (04) e1002783
  • 3 Abalos E, Cuesta C, Carroli G. et al; WHO Multicountry Survey on Maternal and Newborn Health Research Network. Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG 2014; 121 (Suppl. 01) 14-24
  • 4 Oladapo OT, Adetoro OO, Ekele BA. et al; Nigeria Near-miss and Maternal Death Surveillance Network. When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country. BJOG 2016; 123 (06) 928-938
  • 5 Sawicki E, Stewart K, Wong S, Leung L, Paul E, George J. Medication use for chronic health conditions by pregnant women attending an Australian maternity hospital. Aust N Z J Obstet Gynaecol 2011; 51 (04) 333-338
  • 6 Yeonhee K, Jongcheul S, Yeon-Hee K, Jong Chul S. Management of chronic hypertension in pregnancy. J Korean Med Assoc 2015; 58 (10) 897-904
  • 7 Foo L, Tay J, Lees CC, McEniery CM, Wilkinson IB. Hypertension in pregnancy: natural history and treatment options. Curr Hypertens Rep 2015; 17 (05) 36
  • 8 Martinovic J, Benachi A, Laurent N, Daïkha-Dahmane F, Gubler MC. Fetal toxic effects and angiotensin-II-receptor antagonists. Lancet 2001; 358 (9277): 241-242
  • 9 Shotan A, Widerhorn J, Hurst A, Elkayam U. Risks of angiotensin-converting enzyme inhibition during pregnancy: experimental and clinical evidence, potential mechanisms, and recommendations for use. Am J Med 1994; 96 (05) 451-456
  • 10 Schroeder BM. American College of Obstetricians and Gynecologists. ACOG practice bulletin on diagnosing and managing preeclampsia and eclampsia. Am Fam Physician 2002; 66 (02) 330-331
  • 11 American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 125: chronic hypertension in pregnancy. Obstet Gynecol 2012; 119 (2 Pt 1): 396-407
  • 12 Singh S, Ahmed EB, Egondu SC, Ikechukwu NE. Hypertensive disorders in pregnancy among pregnant women in a Nigerian Teaching Hospital. Niger Med J 2014; 55 (05) 384-388
  • 13 Tessema GA, Tekeste A, Ayele TA. Preeclampsia and associated factors among pregnant women attending antenatal care in Dessie referral hospital, Northeast Ethiopia: a hospital-based study. BMC Pregnancy Childbirth 2015; 15: 73
  • 14 Onoh RC, Onyebuchi KA, Mamah JE, Anozie BO, Kenneth EC, Chidi EO. Obstetric outcome of pregnancies complicated by hypertensive disorders of pregnancy. Sahel Med J. 2020; 23 (03) 141
  • 15 Shan D, Qiu PY, Wu YX. et al. Pregnancy outcomes in women of advanced maternal age: a retrospective cohort study from China. Sci Rep 2018; 8 (01) 12239
  • 16 MacKay AP, Berg CJ, Atrash HK. Pregnancy-related mortality from preeclampsia and eclampsia. Obstet Gynecol 2001; 97 (04) 533-538
  • 17 Heard AR, Dekker GA, Chan A, Jacobs DJ, Vreeburg SA, Priest KR. Hypertension during pregnancy in South Australia, part 1: pregnancy outcomes. Aust N Z J Obstet Gynaecol 2004; 44 (05) 404-409
  • 18 Musa J, Mohammed C, Ocheke A, Kahansim M, Pam V, Daru P. Incidence and risk factors for pre-eclampsia in Jos Nigeria. Afr Health Sci 2018; 18 (03) 584-595
  • 19 Chiu M, Austin PC, Manuel DG, Shah BR, Tu JV. Deriving ethnic-specific BMI cutoff points for assessing diabetes risk. Diabetes Care 2011; 34 (08) 1741-1748
  • 20 Rahman MM, Abe SK, Kanda M. et al. Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis. Obes Rev 2015; 16 (09) 758-770
  • 21 English FA, Kenny LC, McCarthy FP. Risk factors and effective management of preeclampsia. Integr Blood Press Control 2015; 8: 7-12
  • 22 Cooper WO, Hernandez-Diaz S, Arbogast PG. et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med 2006; 354 (23) 2443-2451
  • 23 Webster LM, Reed K, Myers JE. et al. Quantifying adherence to antihypertensive medication for chronic hypertension during pregnancy. Pregnancy Hypertens 2019; 17: 12-14
  • 24 Lupattelli A, Spigset O, Nordeng H. Adherence to medication for chronic disorders during pregnancy: results from a multinational study. Int J Clin Pharm 2014; 36 (01) 145-153