Fetomaternal outcomes among normotensive and stage one hypertensive patients at a tertiary hospital in western Kenya: A prospective cohort study

Abstract

Background: The American Heart Association now defines blood pressure range between 130/80 to 139/89 as stage one hypertension.  The effect of this blood pressure range on pregnancy outcomes is not well studied especially in SubSaharan Africa. Major obstetric  authorities recognize the need for further studies on the effects of the newly defined stage one hypertension on pregnancy.

Objective: To compare the fetomaternal outcomes between normotensive and stage one hypertensive patients at a tertiary hospital in Western  Kenya.

Methods: A prospective cohort study of 320 women between 15 to 49 years at Jaramogi Oginga Odinga Teaching and Referral  Hospital. Non-probability consecutive sampling was used to recruit participants who were either normotensive or stage one hypertensive  per the revised American Heart Association criteria. Both descriptive and inferential analyses were employed. Covariates  with p-value < 0.05 were considered significant.

Results: 15.9% of the participants in the stage one hypertensive group developed gestational hypertension compared to 5.5% in the normotensive group. 17.9% of neonates born to participants with stage one  hypertension required NBU admission compared to 10.3% in the normotensive group. 30.3% of neonates born to participants in the stage  one hypertensive group had APGAR scores below 7 at one minute compared to 20.0% in the normotensive group.

Conclusion: Patients with stage one hypertension per the new American Heart Association criteria have an increased risk of getting both adverse fetal  and maternal outcomes.