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Hypertensive disease in pregnancy in Botswana: Prevalence and impact on perinatal outcomes

Katherine M Johnson1, Rebecca Zash2, Miriam J Haviland1

  • 1Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, United States.

Pregnancy Hypertension
|December 13, 2016
PubMed

Insights

Hypertension in pregnancy is common in Botswana, significantly increasing risks for stillbirth, preterm birth, and neonatal death. Early detection and management are crucial for improving perinatal outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Health
  • Public Health in Sub-Saharan Africa

Background:

  • Hypertension in pregnancy is a significant contributor to perinatal morbidity in sub-Saharan Africa.
  • Limited data exists on the prevalence and impact of pregnancy hypertension in this region.
  • Previous research has focused on infection, obstetric emergencies, and preterm birth.

Purpose of the Study:

  • To determine the prevalence of hypertension in pregnancy in Botswana.
  • To evaluate the impact of pregnancy hypertension on perinatal outcomes.
  • To inform strategies for improving maternal and infant health in the region.

Main Methods:

  • Surveillance of obstetric records from eight major public hospitals in Botswana.
  • Inclusion criteria: HIV-uninfected women with singleton gestations and at least one prenatal blood pressure measurement.
  • Outcomes measured: stillbirth, preterm birth, small for gestational age, and neonatal death.

Main Results:

  • Hypertension occurred in 22.2% of 14,170 pregnancies; 19.1% were severe.
  • Severe hypertension significantly increased risks for stillbirth (RR 4.4), preterm birth (RR 2.5), small for gestational age (RR 2.7), and neonatal death (RR 5.1).
  • Non-severe hypertension also elevated risks for stillbirth, preterm birth, and small for gestational age.

Conclusions:

  • Pregnancy hypertension is highly prevalent in Botswana and associated with substantial adverse perinatal outcomes.
  • Effective management of hypertension in pregnancy is essential for reducing perinatal morbidity and mortality.
  • Further research and improved clinical practices are needed to address this public health challenge.
Abstract

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