Font Size: 

Abstract

Background: Hypertensive disease of pregnancy (HDP) are multisystem diseases, which include chronic hypertension, superimposed preeclampsia on chronic hypertension, gestational hypertension, preeclampsia, and eclampsia. Studies have revealed that hypertension increased risk of preterm birth, small for gestational age, stillbirth and neonatal death. But, pooled prevalence of hypertensive disorders and their pregnancy outcomes in Africa have not been well understood. Therefore; this review aimed at analyzing prevalence of hypertensive disease of pregnancy and pregnancy outcomes in sub-Saharan Africa.

Method: A systematic review of articles using PubMed, EMBASE, AJOL and Google scholar was done.  This analysis was conducted on observational facility based studies from sixteen countries between 2000 and 2018 in sub-Saharan Africa. Independent extraction of articles by review authors using predefined inclusion criteria were done. Adjusted odds ratio with 95% confidence intervals for each study were calculated and across studies using the random effects model with the comprehensive meta-analysis version 2 package. Heterogeneity (I²) was calculated for combined studies.

Result: The analysis included 59 studies. The overall pooled prevalence of hypertensive disease of pregnancy was 4.1% (95% CI = (3.1%, 5.3%)), but the meta-analysis has high heterogeneity, I² = 99.45% P-value < 0.0001. Compared with normotensive pregnant women, women with hypertensive disease of pregnancy were associated with increased risk of maternal mortality, OR = 17 (95% CI = (9.6, 28.8)), cesarean section, OR = 3.1 (95% CI = (1.7, 5.6)), perinatal mortality, OR= 8.2 (95% CI = (2.8, 24)), low birth weight, OR = 3.2 (95% CI = (2, 5))  and preterm delivery, OR = 7.8 (95% CI = (2.5, 25.3)) according to this analysis.

Conclusion: The pooled prevalence of hypertensive disease of pregnancy was high compared to those reported from other region. Maternal mortality, cesarean section, perinatal mortality, low birth weight and preterm delivery have been significantly associated with hypertensive disease of pregnancy. Therefore; creating awareness on hypertensive disease of pregnancy among pregnant women is mandatory.  Pregnant women with hypertensive disease of pregnancy need due attentions to manage the disease appropriately in order to have favorable outcomes.