Illness pattern and Pregnancy Outcomes among Women with Chronic Medical Conditions in a Hospital in Ibadan
DOI:
https://doi.org/10.60787/tnhj.v24i3.863Keywords:
Birth outcomes, Diabetes, Hypertension,, Maternal mortality, Neonatal mortality, PregnancyAbstract
Background: Pregnancy associated with an underlying chronic/medical disorder has a huge impact on both maternal and fetal well-being. This study examined the pattern of illness and pregnancy outcomes among women with chronic illnesses in pregnancy.
Method: Using a retrospective survey design, 216 case notes of women with at least one chronic condition, delivered in a secondary health care facility in Ibadan city were examined. Data on maternal characteristics, obstetric and social history and birth outcomes were collected. Statistical Package for Social Sciences (SPSS 20.0) was used for data analysis. Frequencies, mean and percentages were used in descriptive data analysis while Pearson’s chi-square statistics was used in testing the hypotheses.
Result: Mean age was 30.10 (±5.8) years, with 70.1% being married. About half (49.5%) had a family history of chronic illness and over a third (36.1%) took alcohol. The most prevalent chronic illness was hypertension (23.1%), followed by co-morbid diabetes and hypertension (19.9%). Adverse maternal outcomes included mortality (4.2%), postpartum haemorrhage (17%) and extended length of hospital stay (48.6%). Adverse fetal outcomes included neonatal mortality (3.2%), stillbirth (3.2%); Neonatal Intensive Care Unit admission (24.5%). There was a significant relationship between multiple chronic conditions and extended hospital stay (p<0.01) maternal mortality (p<0.01) and birth outcomes (p<0.05).
Conclusion: Significant adverse outcomes including maternal and neonatal death, were associated with chronic disease (s) in pregnancy. These outcomes were worse in women with multiple chronic conditions. Policies and programmes directed at preventing and managing chronic diseases in pregnancy should be intensified at secondary healthcare facilities.
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References
Cho GJ, Kim J, Kim JY, et al. Adverse Pregnancy Outcomes and Maternal Chronic Diseases in the Future: A Cross-Sectional Study Using KoGES-HEXA Data. J Clin Med. 2022;11(5). doi:10.3390/jcm11051457
Olonade O, Olawande TI, Alabi OJ, Imhonopi D. Maternal mortality and maternal health care in Nigeria: Implications for socio-economic development. Open Access Maced J Med Sci. 2019;7(5):849-855. doi:10.3889/oamjms.2019.041
World Health Organisation. Maternal mortality. Accessed March 2, 2024. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
Singh GK, Lee H. Trends and Racial/Ethnic, Socioeconomic, and Geographic Disparities in Maternal Mortality from Indirect Obstetric Causes in the United States, 1999-2017. International Journal of Maternal and Child Health and AIDS (IJMA). 2020;10(1):43-54. doi:10.21106/ijma.448
Lee SI, Azcoaga-Lorenzo A, Agrawal U, et al. Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study. BMC Pregnancy Childbirth. 2022;22(1). doi:10.1186/s12884-022-04442-3
Subki AH, Algethami MR, Baabdullah WM, et al. Prevalence, risk factors, and fetal and maternal outcomes of hypertensive disorders of pregnancy: A retrospective study in Western Saudi Arabia. Oman Med J. 2018;33(5):409-415. doi:10.5001/omj.2018.75
Musarandega R, Nyakura M, Machekano R, Pattinson R, Munjanja SP. Causes of maternal mortality in SubSaharan Africa: A systematic review of studies published from 2015 to 2020. J Glob Health. 2021;11. doi:10.7189/JOGH.11.04048
Olamijulo JA, Olorunfemi G, Okunola H. Trends and causes of maternal death at the Lagos University teaching hospital, Lagos, Nigeria (2007–2019). BMC Pregnancy Childbirth. 2022;22(1). doi:10.1186/s12884-022-04649-4
Firoz T, Pineles B, Navrange N, Grimshaw A, Oladapo O, Chou D. Non-communicable diseases and maternal health: a scoping review. BMC Pregnancy Childbirth. 2022;22(1). doi:10.1186/s12884-022-05047-6
De Moura MDR, Margotto PR, Costa KN, Garbi Novaes MRC. Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks. PLoS One. 2021;16(8 August). doi: 10.1371/journal.pone.0255783
Ornoy A, Becker M, Weinstein-Fudim L, Ergaz Z. Diabetes during pregnancy: A maternal disease complicating the course of pregnancy with long-term deleterious effects on the offspring. a clinical review. Int J Mol Sci. 2021;22(6):1-38. doi:10.3390/ijms22062965
Gemechu KS, Assefa N, Mengistie B. Prevalence of hypertensive disorders of pregnancy and pregnancy outcomes in Sub-Saharan Africa: A systematic review and meta-analysis. Women’s Health. 2020;16. doi:10.1177/1745506520973105
Babah OA, Owie E, Ohazurike EO, Akinajo OR. Prevalence and pattern of medical disorders in pregnancy at the time of delivery at Lagos University Teaching Hospital, Lagos, Nigeria. Sub-Saharan African Journal of Medicine. 2018;5(3):93.
Brown HK, McKnight A, Aker A. Association between pre-pregnancy multimorbidity and adverse maternal outcomes: A systematic review. Journal of Multimorbidity and Comorbidity. 2022; 12:263355652210965. doi:10.1177/26335565221096584
Tanner MS, Malhotra A, Davey MA, et al. Maternal and neonatal complications in women with medical comorbidities and preeclampsia. Pregnancy hypertension. Published 2022. Accessed March 2, 2024.
https://www.sciencedirect.com/science/article/abs/pii/S2210778921005560?via%3Dihub
Njie AE, Nyandiko WM, Ahoya PA, Moutchia JS. A comparative analysis of APGAR score and the gold standard in the diagnosis of birth asphyxia at a tertiary health facility in Kenya. PLoS One. 2023;18(5 May). doi: 10.1371/journal.pone.0285828
Battarbee AN, Sinkey RG, Harper LM, Oparil S, Tita ATN. Chronic hypertension in pregnancy. American journal of obstetrics and gynecology. 2020;222(6):531-541. Accessed March 20, 2024. https://pubmed.ncbi.nlm.nih.gov/31715148/
Shah S. Hypertensive Disorders in Pregnancy. Obstetric and Gynecologic Nephrology: Women’s Health Issues in the Patient with Kidney Disease. doi:10.1007/978-3-030-25324-0_2
Sobrevia L, Moshi FV, Lake G, Sintayehu Y, Balis B, Bekele H. Magnitude of Cesarean-Section and Associated Factors among Diabetic Mothers in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Study.
Corrigan L, O’Farrell A, Moran P, Daly D. Hypertension in pregnancy: Prevalence, risk factors and outcomes for women birthing in Ireland. Pregnancy Hypertens. 2021; 24:1-6. doi: 10.1016/j.preghy.2021.02.005
Olufemi Opeyemi A, Victor Idowu JM, Olukayode Samuel BZ, Ayobami Oyetunji A. Determinants of Birth Weight in Southwestern Nigeria. J Med Res. 2019;5(2):79-83. www.medicinearticle.com
Pereda J, Bove I, Pineyro MM. Excessive Maternal Weight and Diabetes Are Risk Factors for Macrosomia: A Cross-Sectional Study of 42,663 Pregnancies in Uruguay. Front Endocrinol (Lausanne). 2020;11. doi:10.3389/fendo.2020.588443
Belay DM, Bayih WA, Alemu AY, et al. Macrosomia and its predictors in pregnant women with diabetes in Ethiopia. Tropical Medicine and International Health. 2021;26(12):1539-1552. doi:10.1111/tmi.13684
Abinaya M, Taye MK, Saikia N, Teron L, Kalita P. The effect of comorbidities of preeclampsia and eclampsia on maternal and fetal outcome. Int J Reprod Contracept Obstet Gynecol. 2023;12(3):721-725. doi:10.18203/2320-1770.ijrcog20230545
Admon LK, Winkelman TNA, Heisler M, Dalton VK. Obstetric outcomes and delivery-related health care utilization and costs among pregnant women with multiple chronic conditions. Prev Chronic Dis. 2018;15(2). doi:10.5888/pcd15.170397
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