Prevalence and self-care practice of Pregnancy-Induced Hypertension (PIH) in Ghana: a facility-based cross-sectional study

Abstract

The United Nations’ Sustainable Development Goal 3 aims to reduce the global maternal mortality ratio to 70 per 100,000 live births by 2030, yet PIH remains a significant barrier to achieving this target. In Ghana, the situation is particularly concerning, with the maternal mortality rate currently estimated at 319 deaths per 100,000 live births. This study assessed the prevalence and self-care practice of PIH among pregnant women in the Amansie South District, in the Ashanti Region of Ghana. A facility-based cross-sectional study was conducted among pregnant women attending antenatal care in the Amansie South District, Ghana. Antenatal care registers were reviewed to identify pregnant women clinically diagnosed with PIH. Of the 1,455 pregnant women attending ANC during the study period, 276 women with PIH were identified and contacted to participate in the study. Data was collected using Kobo collect tool. Data cleaning and analysis was carried out in STATA V.17.0. Bivariate logistic regression analysis was used to measure the factors associated with self-care practice of PIH. Variables with p-values < 0.05 from bivariate analysis were considered for a forward stepwise multivariate logistic regression analysis. A p-value < 0.05 was considered statistically significant. The prevalence of PIH in the Amansie South District was 18.9%, and more than half of these hypertensive pregnant women demonstrated poor self-care practice (55.4%). In the multivariable analysis, respondents who were Christians had significantly lower odds of poor self-care practice compared with African traditionalists (AOR = 0.28, 95% CI: 0.10–0.80). Married women had lower odds of poor self-care practice compared with never-married women (AOR = 0.44, 95% CI: 0.22–0.86). Similarly, healthcare workers were less likely to have poor self-care practice compared with unemployed women (AOR = 0.45, 95% CI: 0.22–0.90), while women with tertiary education (college/university) had lower odds of poor self-care practice compared with those with no formal education (AOR = 0.55, 95% CI: 0.14–0.22). The study reveals that the prevalence of PIH in the Amansie South District was high. Pregnant women diagnosed with PIH were found to demonstrate a poor level of self-care practice. Factors such as religion, educational level, occupation, and marital status were found to be associated with self-care practice of PIH among respondents. The findings emphasize the critical need for targeted public health interventions to manage and prevent PIH, given its potential association with increased maternal and neonatal morbidity and mortality.