Dietary determinant of hypertensive disorders among pregnant women attending antenatal and delivery care in public hospitals of jimma zone, southwest Ethiopia

Abstract

Background: Hypertensive disorders of pregnancy are a major contributor to maternal and perinatal morbidity and mortality.A recent review reported that in Ethiopia hypertensive disorders of pregnancy complicate around 6% of all and accounts for 19% of all maternal deaths. Eating pattern is one of the modifiable deteriminant of hypertension which gives synergestic effect than single nutrient. However, there is evidence gap in Ethiopia to see the association between dietary patterns and hypertensive disorders of pregnancy. Objective: The aim of this study was to identify dietary determinants of hypertensive disorders of pregnancy among pregnant mothers attending antenatal and delivery care. Methods: Institution based unmatched case control study was conducted from April 15 to July 10 in selected public hospitals of Jimma zone. A total of 333 participants (111 cases and 222 controls) were included. Data were collected using an interviewer administered questionnaire and entered to Epi data version 3.1 then analyzed using SPSS version 20. Variables in the bivariate logistic regression with p value < 0.25 were selected as candidate for multivariable analysis. Adjusted odds ratio with 95% confidence interval is reported. Significance was declared at P-value ≤ 0.05. Principal component analysis was used to identify wealth tertile and cluster analysis was used to derive dietary pattern. Finally, model fitness was tested using Hosmer-Lemshow goodness-of-fit test. Result: On multivariable analysis after adjusting for confounders’ plant based AOR =0.36 CI: 0.15-0.82] and balanced type of dietary pattern [AOR = 0.24 CI: 0.11-0.51] and folate intake [AOR=0.17 CI: 0.06-0.48] found to be significant protective factors from hypertensive disorders of pregnancy. Previous history of pregnancy induced hypertension [AOR=3.76 CI: 1.67-8.37], rural residence [AOR=5.12 CI: 2.45-10.79], twin pregnancy [AOR 3.69 CI: 1.52-8.96], history of abortion AOR=2.37 CI: 1.10-5.12], presence of anemia at the first visit [AOR=7.12 CI :2.30- 21.98], advanced age [AOR=4.44 CI: 1.52-12.97], gestational diabetes [AOR=3.12 CI: 1.002- 9.72] and highest wealth index [AOR 4.17 CI: 1.27-13.66] found to be significant risk factors for hypertensive disorders during pregnancy. IV Conclusion: The findings showed that balanced food based dietary pattern and plant based food pattern had direct protective relationship with development of hypertension during pregnancy. The findings imply the need for promoting consumption of balanced diets and plant source foods high in fruit and vegetables specially focusing on those with twin pregnancies, anemia at first visit, previous history of pregnancy induced hypertension, rural residents and advanced age groups