# Incidence and Pattern of Hypertensive Disorders of Pregnancy in Akwa Ibom and Cross River States, Nigeria

## TL;DR

This study examines how common and what types of high blood pressure disorders occur during pregnancy in two Nigerian states, finding that pre-eclampsia is the most frequent.

## Contribution

The study provides new data on the incidence and pattern of hypertensive disorders of pregnancy in Akwa Ibom and Cross River states, Nigeria.

## Key findings

- The period prevalence of hypertensive disorders of pregnancy was 28.7% in the study population.
- Pre-eclampsia was the most common form of HDP, affecting 23.9% of participants.
- Only 2.5% of participants had chronic hypertension.

## Abstract

Introduction: Hypertensive disorders of pregnancy (HDP) are the leading cause of maternal and perinatal morbidity and mortality in developing countries. The incidence and pattern of these disorders are not known in most of these countries. Hence, the need to determine the incidence and pattern of these disorders in Akwa Ibom State (AKS) and Cross River State (CRS) of Nigeria.

Methods: In a prospective cohort study, all pregnant women who presented at the booking clinics of the referral level hospitals in AKS and CRS over a ten-month period (February 2023 to November 2023) were screened. Those with a confirmed gestational age of ≤20 weeks, whether hypertensive or normotensive, who gave their informed consent were recruited for the study and followed up till delivery. Data collected included age, parity, gestational age at enrollment, educational status, and marital status. Booking Blood pressure, weight, and height were measured, and qualitative urine protein status was also obtained for each participant. The data obtained were analyzed using STATA (version 16, StataCorp, TX, USA).

Results: Of the 1,006 participants that were followed up till delivery in this study, 25 had chronic hypertension, 240 had pre-eclampsia, and 24 had gestational hypertension. Those married were 967/1,006 (96.1%) and 447/1,006 (44.4%) were in private businesses. The majority of them had up to secondary 322/1,006 (32%) or tertiary 652/1,006 (64.8%) level of education. The period prevalence of HDP in the study population was 28.7% (289/1,006) and 2.5% (25/1,006) for chronic hypertension. The incidence of HDP was 26.9% (264/981); 24.5% (240/981) for pre-eclampsia and 2.4% (24/981) for gestational hypertension in the study population. The patterns of HDP were 2.5% (25/1,006) for chronic hypertension; 23.9% (240/1,006) for pre-eclampsia; and 2.4% 24/1,006) for gestational hypertension in the study population.

Conclusion: The incidence and prevalence of HDP in both AKS and CRS are high. Pre-eclampsia is the most common form of HDP in these states. There is a need for thorough screening for HDP in our antenatal clinics, identification of risk factors, and implementation of strategies to improve the outcomes of HDP in these states.