Associated risk factors with pregnancy-induced hypertension : A hospital-based KAP study

Background: Hypertension, complicating 5-10% of all pregnancies, is a leading cause of maternal and fetal morbidity, particularly when the elevated blood pressure is due to preeclampsia. The control of pregnancy-induced hypertension (PIH) appears diffi cult to achieve. Part of the reason for poor control of hypertension in these women might be limited PIH self-care knowledge. Aims: The aim was to fi nd out the association between PIH and knowledge, attitude, and preventive practices among pregnant women. Settings and Design: A cross-sectional study was carried out in Gynae O.P.D., of Sir Sundar Lal Hospital, Banaras Hindu University, Varanasi. Materials and Methods: The study was carried out in the month of September to October, 2013 on every Monday in Gynae O.P.D., of Sir Sundar Lal Hospital, Banaras Hindu University, Varanasi. The target population includes all pregnant women between the age group of 15-49 years, who attended antenatal clinic. The interview schedules were administered to the women. Respondents were assured of anonymity and confi dentiality to ensure honest response. Statistical Analysis Used: Statistical analysis will be done by Epi InfoTM 7. Results and Conclusion: Finding of the study shows that >50% (60.49%) of women are unaware about hypertension. Those women belong to the age group of 20-30, and they also diagnosed with prehypertension. The overall incidence of Eclampsia is 13.58% in study population regarding PIH. Lack of exercise is a major cause to for hypertension. Pregnancies complicated by hypertensive disorders lead poor maternal and perinatal outcomes.


INTRODUCTION
Pregnancy-induced hypertension (PIH) known as toxemia or preeclampsia is a form of high blood pressure (BP) in pregnancy.It is one of the leading causes of mortality and morbidity among pregnant women.As stated by the WHO, World Health Report (2005) "Make Every Mother and Child Count," the major causes of maternal deaths are severe bleeding/hemorrhage (25%), infections (13%), unsafe abortions (13%), eclampsia (12%), obstructed labor (8%), other direct causes (8%), and indirect causes (20%).
Pregnancy-induced hypertension occurs in about 5-8% of all pregnancies.Although the cause of PIH is unknown, certain factors are known to increase the risk of PIH, such risk factors include that PIH mostly affects young women with a fi rst pregnancy, pregnant women younger than 20 years and those older than 40 years, women with multiple fetuses, pregnant diabetics, pregnant women with preexisting hypertension or previous episodes of preeclampsia or PIH and pregnant women with preexisting renal disease. [1]oblem burden of pregnancy-induced hypertension  Symptoms and associated risk of developing pregnancy-induced hypertension [2] Symptoms

Gestational hypertension
• High BP that develops after week 20 in pregnancy and goes away after delivery.

Preeclampsia
• Both chronic hypertension and gestational hypertension can lead to this severe condition after week 20 of pregnancy.Symptoms include high BP and protein in the urine and can lead to serious complications for both mom and baby if not treated quickly. [3]gh risk of developing preeclampsia by respondents and assured them for anonymity and confi dentiality to ensure honest response.

Analysis of data
Data were analyzed using the Epi Info ™ 7 (Centers for Disease Control and Prevention (CDC), Atlanta, Georgia USA).It consisted of descriptive statistics including calculation of the frequencies, mean scores for the items.

RESULT AND DISCUSSION
Table 1 shows that more than half of the women (≈63%) belong to rural areas, who attended antenatal clinic, at Sir Sundar Lal Hospital.
Table 2 shows that more than half of the women (64.63%) belong to the age group of 18-27 years while others (≈35%) from the age group of 28-36 years.
Table 3 shows that Epigastric Pain is the most common problem among pregnant women (more than half the women ≈54% having the problem of Epigastric Pain), while Headache is secondary cause among pregnant women who attended antenatal clinic, at Sir Sundar Lal Hospital.
Table 4 shows that the overall incidence of Eclampsia is 14.63% in study population regarding PIH.A study done by Vidyadhar B Bangal, Purushottam A. Giri, Aditi S. Mahajan entitled as Maternal and Foetal Outcome in PIH: A Study from Rural Tertiary Care Teaching Hospital in India, found that the overall incidence of PIH was 8.96%, which includes preeclampsia in 7.26% and eclampsia in 1.70%. [5]ble 5 shows that on the basis of systolic blood pressure, >1/4 th population are diagnosed with prehypertension whereas on the basis of diastolic blood pressure, 25.97% of the study population are diagnosed with stage of prehypertension remaining are come under the normal category.
Table 6 shows that 36.59%women are unaware about the cause of high BP whereas 31.71%women says that lack of exercise is measure cause of high BP.
According to Table 7, 62.20% women are agreed with that they are taking low salt diet whiles other are taking normal as well as high salt diet.
Table 8 shows that more than half of the women are doing regular exercise while other are not doing any exercise.

CONCLUSIONS
Pregnancy-induced hypertension is a common medical disorder seen associated with pregnancy, and it leads more complication when it unregistered.Maternal and fetal morbidity and mortality can be reduced by early recognition and institutional management.
Considering the fi ndings obtained in the study

Association between knowledge and practice
Figure 1 shows that there is a vast gap between self-care knowledge and preventive practices among pregnant women.Less than 50% women are doing exercise during pregnancy while they all know that lack of exercise is a cause of high BP.Only 61.54% women are taking low salt diet among all women who agreed that high salt diet is major cause of high BP.
And actual number of followers Yes -8 and No -5

Figure 1 :
Figure 1: Association between knowledge and practices regarding high blood pressure

of PIH Risk of developing PIH
Lung and Blood Institute.JNC 7 Express.The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, 2003 International Journal of Medicine and Public Health | Jan-Mar 2015 | Vol 5 | Issue 1

Table 6 : Reason behind high BP Reason behind high BP Frequency Percentage 95% confi dence interval limits
BP = Blood pressure International Journal of Medicine and Public Health | Jan-Mar 2015 | Vol 5 | Issue 1 •To prevent PIH, there must be check BP at regular interval and • Not only educate the Pregnant Women on the symptoms of PIH but also motivate them take preventive measures as a requirement.
How to cite this article: Singh V, Srivastava M. Associated risk factors with pregnancy-induced hypertension: A hospital-based KAP study.Int J Med Public Health 2015;5:59-62.Source of Support: Nil, Confl ict of Interest: None declared.