Hypertension Persisting after Pre-Eclampsia: A Prospective Cohort Study at Mulago Hospital, Uganda
Identifieur interne : 002704 ( Main/Exploration ); précédent : 002703; suivant : 002705Hypertension Persisting after Pre-Eclampsia: A Prospective Cohort Study at Mulago Hospital, Uganda
Auteurs : Annettee Nakimuli [Ouganda] ; Alison M. Elliott [Royaume-Uni] ; Pontiano Kaleebu [Ouganda] ; Ashley Moffett [Royaume-Uni] ; Florence Mirembe [Ouganda]Source :
- PLoS ONE [ 1932-6203 ] ; 2013.
Abstract
Pre-eclampsia/eclampsia usually resolves after delivery but sometimes hypertension persists and cardiovascular disease develops later. Our objective was to determine the incidence and maternal socio-demographic and obstetric risk factors for persistence of hypertension in women with pre-eclampsia/eclampsia.
This was a prospective cohort study conducted from July 2009 to June 2011 at Mulago Hospital labour ward and postnatal clinics. We followed up 188 women admitted with pre-eclampsia/eclampsia until 3 months after delivery. Data was collected using interviewer-administered questionnaires, examination of participants and review of medical records. Stata (version12) software was used for data analysis. Univariable analysis was used to compute the relative risk of persistent hypertension at the 95% confidence level. This was followed by multivariable logistic regression analysis to determine factors independently associated with persistence of hypertension.
64 (34%) out of the 188 women analysed had persistent hypertension three months after delivery. Maternal age, gestational age at delivery and parity were predictors of persistent hypertension.
The proportion of women with pre-eclampsia/eclampsia at risk of persistent hypertension at three months after delivery was high, with nearly one of three mothers remaining hypertensive. Follow up of mothers who develop pre-eclampsia is important so that early diagnosis and management of chronic hypertension can be made to avoid long term morbidity and mortality.
Url:
DOI: 10.1371/journal.pone.0085273
PubMed: 24392003
PubMed Central: 3877387
Affiliations:
- Ouganda, Royaume-Uni
- Angleterre, Angleterre de l'Est, Grand Londres
- Cambridge, Londres
- Université de Cambridge
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Elliott</name><affiliation wicri:level="3"><nlm:aff id="aff2"><addr-line>Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda and London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda and London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Kaleebu, Pontiano" sort="Kaleebu, Pontiano" uniqKey="Kaleebu P" first="Pontiano" last="Kaleebu">Pontiano Kaleebu</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe</wicri:regionArea><wicri:noRegion>Entebbe</wicri:noRegion></affiliation></author><author><name sortKey="Moffett, Ashley" sort="Moffett, Ashley" uniqKey="Moffett A" first="Ashley" last="Moffett">Ashley Moffett</name><affiliation wicri:level="4"><nlm:aff id="aff4"><addr-line>Department of Pathology, University of Cambridge, Cambridge, United Kingdom and Centre for Trophoblast Research, Cambridge, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Pathology, University of Cambridge, Cambridge, United Kingdom and Centre for Trophoblast Research, Cambridge</wicri:regionArea><orgName type="university">Université de Cambridge</orgName><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName></affiliation></author><author><name sortKey="Mirembe, Florence" sort="Mirembe, Florence" uniqKey="Mirembe F" first="Florence" last="Mirembe">Florence Mirembe</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24392003</idno><idno type="pmc">3877387</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877387</idno><idno type="RBID">PMC:3877387</idno><idno type="doi">10.1371/journal.pone.0085273</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">002A75</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002A75</idno><idno type="wicri:Area/Pmc/Curation">002A74</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002A74</idno><idno type="wicri:Area/Pmc/Checkpoint">001898</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001898</idno><idno type="wicri:Area/Ncbi/Merge">002655</idno><idno type="wicri:Area/Ncbi/Curation">002655</idno><idno type="wicri:Area/Ncbi/Checkpoint">002655</idno><idno type="wicri:Area/Main/Merge">002711</idno><idno type="wicri:Area/Main/Curation">002704</idno><idno type="wicri:Area/Main/Exploration">002704</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Hypertension Persisting after Pre-Eclampsia: A Prospective Cohort Study at Mulago Hospital, Uganda </title><author><name sortKey="Nakimuli, Annettee" sort="Nakimuli, Annettee" uniqKey="Nakimuli A" first="Annettee" last="Nakimuli">Annettee Nakimuli</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Elliott, Alison M" sort="Elliott, Alison M" uniqKey="Elliott A" first="Alison M." last="Elliott">Alison M. Elliott</name><affiliation wicri:level="3"><nlm:aff id="aff2"><addr-line>Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda and London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda and London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Kaleebu, Pontiano" sort="Kaleebu, Pontiano" uniqKey="Kaleebu P" first="Pontiano" last="Kaleebu">Pontiano Kaleebu</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe</wicri:regionArea><wicri:noRegion>Entebbe</wicri:noRegion></affiliation></author><author><name sortKey="Moffett, Ashley" sort="Moffett, Ashley" uniqKey="Moffett A" first="Ashley" last="Moffett">Ashley Moffett</name><affiliation wicri:level="4"><nlm:aff id="aff4"><addr-line>Department of Pathology, University of Cambridge, Cambridge, United Kingdom and Centre for Trophoblast Research, Cambridge, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Pathology, University of Cambridge, Cambridge, United Kingdom and Centre for Trophoblast Research, Cambridge</wicri:regionArea><orgName type="university">Université de Cambridge</orgName><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName></affiliation></author><author><name sortKey="Mirembe, Florence" sort="Mirembe, Florence" uniqKey="Mirembe F" first="Florence" last="Mirembe">Florence Mirembe</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec sec-type="headed"><title>Background</title><p>Pre-eclampsia/eclampsia usually resolves after delivery but sometimes hypertension persists and cardiovascular disease develops later. Our objective was to determine the incidence and maternal socio-demographic and obstetric risk factors for persistence of hypertension in women with pre-eclampsia/eclampsia.</p></sec><sec sec-type="headed"><title>Methods</title><p>This was a prospective cohort study conducted from July 2009 to June 2011 at Mulago Hospital labour ward and postnatal clinics. We followed up 188 women admitted with pre-eclampsia/eclampsia until 3 months after delivery. Data was collected using interviewer-administered questionnaires, examination of participants and review of medical records. Stata (version12) software was used for data analysis. Univariable analysis was used to compute the relative risk of persistent hypertension at the 95% confidence level. This was followed by multivariable logistic regression analysis to determine factors independently associated with persistence of hypertension.</p></sec><sec sec-type="headed"><title>Results</title><p>64 (34%) out of the 188 women analysed had persistent hypertension three months after delivery. Maternal age, gestational age at delivery and parity were predictors of persistent hypertension. </p></sec><sec sec-type="headed"><title>Conclusion</title><p>The proportion of women with pre-eclampsia/eclampsia at risk of persistent hypertension at three months after delivery was high, with nearly one of three mothers remaining hypertensive. Follow up of mothers who develop pre-eclampsia is important so that early diagnosis and management of chronic hypertension can be made to avoid long term morbidity and mortality.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Kaye, D" uniqKey="Kaye D">D Kaye</name></author><author><name sortKey="Mirembe, F" uniqKey="Mirembe F">F Mirembe</name></author><author><name sortKey="Aziga, F" uniqKey="Aziga F">F Aziga</name></author><author><name sortKey="Namulema, B" uniqKey="Namulema B">B Namulema</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khan, Ks" uniqKey="Khan K">KS Khan</name></author><author><name sortKey="Wojdyla, D" uniqKey="Wojdyla D">D Wojdyla</name></author><author><name sortKey="Say, L" uniqKey="Say L">L Say</name></author><author><name sortKey="Gulmezoglu, Am" uniqKey="Gulmezoglu A">AM Gülmezoglu</name></author><author><name sortKey="Van Look, Pf" uniqKey="Van Look P">PF Van 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uniqKey="Hiby S">S Hiby</name></author><author><name sortKey="E" uniqKey="E">E</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moffett, A" uniqKey="Moffett A">A Moffett</name></author><author><name sortKey="Hiby, Se" uniqKey="Hiby S">SE Hiby</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Podymow, T" uniqKey="Podymow T">T Podymow</name></author><author><name sortKey="August, P" uniqKey="August P">P August</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sibai, B" uniqKey="Sibai B">B Sibai</name></author><author><name sortKey="Dekker, G" uniqKey="Dekker G">G Dekker</name></author><author><name sortKey="Kupferminc, M" uniqKey="Kupferminc M">M Kupferminc</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Euser, Ag" uniqKey="Euser A">AG Euser</name></author><author><name sortKey="Cipolla, Mj" uniqKey="Cipolla M">MJ Cipolla</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mcdonald, Sd" uniqKey="Mcdonald S">SD McDonald</name></author><author><name sortKey="Malinowski, A" uniqKey="Malinowski A">A Malinowski</name></author><author><name sortKey="Zhou, Q" uniqKey="Zhou Q">Q Zhou</name></author><author><name sortKey="Yusuf, S" uniqKey="Yusuf S">S Yusuf</name></author><author><name sortKey="Devereaux, Pj" uniqKey="Devereaux P">PJ Devereaux</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Ouganda</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Angleterre de l'Est</li><li>Grand Londres</li></region><settlement><li>Cambridge</li><li>Londres</li></settlement><orgName><li>Université de Cambridge</li></orgName></list><tree><country name="Ouganda"><noRegion><name sortKey="Nakimuli, Annettee" sort="Nakimuli, Annettee" uniqKey="Nakimuli A" first="Annettee" last="Nakimuli">Annettee Nakimuli</name></noRegion><name sortKey="Kaleebu, Pontiano" sort="Kaleebu, Pontiano" uniqKey="Kaleebu P" first="Pontiano" last="Kaleebu">Pontiano Kaleebu</name><name sortKey="Mirembe, Florence" sort="Mirembe, Florence" uniqKey="Mirembe F" first="Florence" last="Mirembe">Florence Mirembe</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Elliott, Alison M" sort="Elliott, Alison M" uniqKey="Elliott A" first="Alison M." last="Elliott">Alison M. Elliott</name></region><name sortKey="Moffett, Ashley" sort="Moffett, Ashley" uniqKey="Moffett A" first="Ashley" last="Moffett">Ashley Moffett</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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