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Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study
David Mukunya1,2, Milton W Musaba3,4, Brendah Nambozo5
1Department of Community and Public Health, Busitema University, P.O. Box 1460, Mbale, Uganda.
Insights
Elevated blood pressure is common in children born after obstructed labor, with higher risks in older children and females. Routine screening is recommended for pediatric patients with known risk factors.
Area of Science:
- Pediatric Health
- Cardiovascular Epidemiology
- Obstetric Complications
Background:
- High blood pressure is a leading global cause of mortality.
- Disparities in hypertension-related deaths exist, particularly among Black populations.
- Perinatal insults, like birth asphyxia, may contribute to these disparities.
Purpose of the Study:
- To determine the incidence of elevated blood pressure in children born to mothers with obstructed labor.
- To identify factors associated with elevated blood pressure in this pediatric cohort.
Main Methods:
- A follow-up study of children (25-44 months) born to women with obstructed labor.
- Elevated blood pressure defined as ≥ 90th percentile for age, height, and sex.
- Logistic regression used to analyze associations between exposures and elevated blood pressure.
Main Results:
- The incidence of elevated blood pressure was 27.9%.
- Children aged ≥3 years had double the odds of elevated blood pressure compared to younger children.
- Females and children with reduced estimated glomerular filtration rate had significantly higher odds of elevated blood pressure.
Conclusions:
- A high incidence of elevated blood pressure was observed in children following obstructed labor.
- Routine blood pressure monitoring is advised for pediatric patients, especially those with identified risk factors.
Background:
Globally, high systolic blood pressure accounts for 10.8 million deaths annually. The deaths are disproportionately higher among black people. The reasons for this disparity are poorly understood, but could include a high burden of perinatal insults such as birth asphyxia. Therefore, we aimed to assess the incidence of elevated blood pressure and to explore associated factors among children born to women with obstructed labour.
Methods:
We followed up children born to women with obstructed labour aged 25 to 44 months at Mbale regional referral hospital that had participated in the sodium bicarbonate trial ( Trial registration number PACTR201805003364421) between October 2021 and April 2022. Our primary outcome was elevated blood pressure defined as blood pressure (either systolic or diastolic or both) ≥ the 90th percentile for age, height, and sex in the reference population based on the clinical practice guideline for screening and management of high blood pressure in children and adolescents. We used logistic regression to estimate odds ratios between selected exposures and elevated blood pressure.
Results:
The incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.6-36.1)). Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (Adjusted odds ratio (AOR) 2.46: 95% CI (1.01-5.97). Female participants had 2.81 times the odds of elevated blood pressure as their male counterparts (AOR 2.81 95% CI (1.16-6.82). Participants with reduced estimated glomerular filtration rate had 2.85 times the odds of having elevated blood pressure as those with normal estimated glomerular filtration rate (AOR 2.85 95% CI (1.00-8.13). We found no association between arterial cord lactate, stunting, wealth index, exclusive breastfeeding, food diversity and elevated blood pressure.
Conclusion:
Our findings show a high incidence of elevated blood pressure among children. We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors.
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