Hypertensive Disorders of
Pregnancy (HDP) among
pregnant women in Mukono
district- Uganda
Gloria Naggayi ,James Bagonza, Roy Mayega,
Noah Kiwanuka
Outline
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Introduction and background
Objectives
Location of study site
Methodology
Analysis
Results
Conclusion
Recommendations
Acknowledgements
Background
 HDP: High BP or use antihypertensive treatment
with/without proteinuria of ≥30mg/dl
• High BP: An average systolic BP reading of ≥140mmHg
and / average diastolic BP of ≥90mmHg.
Type of HDP
BP
Gestation
Status age (weeks)
Antihypertensive Proteinuria(mg/dl)
treatment
Chronic
High
≤20
Yes
<30
Gestational
hypertension
High
≥20
No
<30
Pre-eclampsia
High
≥20
No
≥30
Background
• HDP are one of the major causes of 80% of maternal
deaths globally, 6% of maternal deaths in Uganda
• Changes in maternal characteristics is a risk factor to
increase in HDP
• The probability of HDP detection among pregnant
women is 0.28 (UDHS, 2011)
• Prevalence of HDP and associated factors unknown
in Mukono District, Uganda
Study objectives
1. To determine the prevalence of Hypertensive
Disorders of Pregnancy among pregnant women
2. To identify the distribution of the different types
of Hypertensive Disorders of Pregnancy among
pregnant women
3. To identify the factors associated with
Hypertensive Disorders of Pregnancy among
pregnant women
Location of study area
Mukono
district
Methodology
• Cross sectional community survey, March to June 2013
• Study site: Mukono district, central Uganda
• Study Population: pregnant women
• Sample size: 372
• Multi-stage sampling technique was used
• Structured questionnaire
– 2 BP measurements
– A urine sample taken and tested on site for protein
• Ethics approval: MUSPH Higher Degrees Research and
Ethics Committee
Data analysis
• Uni-variate, bivariate and multivariate analysis
(logistic regression) was done
• Prevalence of HDP was calculated as the proportion
of respondents with HDP per 100
• HDP was classified to type using a composite of
gestation age, proteinuria and antihypertensive use
• Odds Ratios and 95% CI were the measures of
association used.
Results
• Total number of participants: 372 pregnant women
• Respondents age ranged from 14 to 41 with a mean
of 24 years (SD= ±4.78, 95% CI (23.87-24.85)
• Their gestation age ranged from 2 to 41 weeks with a
mean of 22.3 (SD= ±9, 95% CI 21.39-23.23)
Prevalence of HDP among pregnant
women in Mukono District
350
310
300
250
200
Frequency
percentage(%)
150
100
83.3
62
50
16.7
0
Normal Pregnacy
Pregnancy with HDP
Distribution of HDP types among
pregnant women in Mukono
District
40
35
30
25
frequency
Percentage
20
15
10
5
0
Chronic hypertension
Gestational hypertension
Pre-eclampsia
Factors associated with HDP
among pregnant women in
Mukono District
Conclusion
• Almost one in every six pregnant women in Mukono
district had a HDP however; 61.3% had chronic
hypertension
• Factors associated with Hypertensive Disorders of
Pregnancy include;
– Older maternal age (Age above 20 years)
– Low diet diversity
– Non attendance of antenatal care
– Primagravida
Recommendations
• Hypertension among women in Mukono district
needs be addressed
• Innovations to increase demand for ANC are crucial
• Quality of diet should be addressed during ANC
Acknowledgements
• Makerere University , College of Health
Sciences, School of Public Health
• Field Epidemiology Training Program Uganda