Effect of Hypertensive Disorders of Pregnancy (HDP) on maternal and perinatal birth outcomes in Eastern Ethiopia: a prospective cohort study

BACKGROUND: Globally, hypertensive disorders of pregnancy are the major causes of maternal and perinatal morbidity and mortality. In low and middle-income countries, including Ethiopia, studies on the effect of hypertensive disorders of pregnancy on maternal and perinatal birth outcomes are limited. OBJECTIVES: The aim of this study was to examine the effect of hypertensive disorders of pregnancy on maternal and perinatal birth outcomes in Eastern Ethiopia. METHODS: We employed a prospective cohort study design involving 374 pregnant women, equally divided into hypertensive ((n = 187) and normotensive (n = 187). Data were collected face to face using an interviewer-administered questionnaire as well as by reviewing the medical records of the mothers. Data analysis was done in STATA Version 17. Binary logistic regression was run to produce risk ratios (relative risk) and 95% confidence intervals along with their p-values were calculated in the bivariate and multivariable analyses. Significance was declared at a P-value of less than 0.05. RESULTS: Compared with normotensive, women with hypertensive disorder had significantly increased risk of developing preterm birth (cRR = 1.8; 95% CI, 1.5, 2.2), stillbirth (cRR = 1.6; 95% CI, 1.3, 2.02), low birth weight (cRR = 1.9; 95% CI, 1.6, 2.3), and early neonatal death (cRR = 1.7; 95% CI, 1.3, 2.3). Women with hypertensive disorders had 2.6 times (aRR = 2.6, 95% CI; 1.2, 5.7) higher risk of perinatal death, and 1.7 (aRR = 1.7; 95%CI, 1.02, 2.90) times higher risk of cesarean section delivery compared with the normotensive women controlling the other variables. CONCLUSION: Significant risk of cesarean section delivery, perinatal death, stillbirth, low birth weight delivery, and early neonatal death were reported among women with hypertensive disorders of pregnancy. To minimize the burden of the problem, much has to be done by health care professionals and stakeholders focusing on the identification and proper management of mothers with hypertensive disorders.