The determinants of pregnancy-induced hypertension among pregnant women in the urban and rural areas in the Ashanti region of Ghana

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Hypertensive disorders among pregnant women account for 12 to 20 percent of the total maternal deaths in the world. Yet in spite of it being identified as the most common medical problem encountered during pregnancy, pregnancy-induced hypertension has received less research attention. Using an exploratory cross-sectional design and a random sample of 250 women in the third trimester of their pregnancy, this study determined the factors that account for the incidence of pregnancy-induced hypertension (PIH) among women in urban and rural area in the Ashanti Region of Ghana. Specifically, the study ascertained the level of knowledge of pregnant women on PIH, determined the prevalence of PIH among the sample, evaluated the relationship between PIH risk factors and development of PIH, and identified proximate determinants of PIH among the pregnant women. Data for the study was collected through the use of a structured questionnaire and analyzed using the SPSS (v20) software programme. Descriptive statistics such as frequencies, percentages and means were used for univariate analysis. Relationship between PIH risk factors and PIH status was determined by Pearson correlation and chi-square test for independence. Factors which account for incidence of PIH were determined through the multivariate analysis technique, specifically logistic regression. The results of the analysis showed a relatively high knowledge of PIH issues among both rural and urban women. Prevalence of PIH among the sample was (16.8%). Compared to rural women, PIH was more prevalent in the urban sample (10.4%). Age, education, hypertensive before current pregnancy, having PIH with pregnancy, family history of hypertension, family history of PIH, having a relative who smokes, eating fatty foods, and having a good appetite as independent factors significantly related with PIH status (p = .038, .013, .000, .000, .014, .030, .002, .039, and .034 respectively). The binary logistic regression analysis to identify the proximate determinants of PIH revealed that these significantly related factors put together, influence the likelihood that pregnant women would develop PIH. However, of these factors only PIH with previous pregnancy proved to be a statistically significant (p = .002) determinant of PIH. Pregnant women who had PIH with their pregnancy were 6 times more likely (OR=6.43) to develop PIH with their current pregnancy. On the basis of this result, it is recommended that pregnant women with a previous history of PIH be advised by their healthcare professionals to increase their prenatal checkups.
Thesis submitted to the Department Of Population, Family And Reproductive Health, College Of Health Sciences, School Of Public Health in partial fulfilment of the requirements for the degree of Master of Science In Public Health In Population and Reproductive Health, 2015