Prevalence of Hypertensive Disorders of Pregnancy and Associated Birth Outcomes Among Adolescent Mothers at a Tertiary Hospital in Zambia: A Retrospective Cross-Sectional Study.

BACKGROUND

Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and perinatal morbidity, yet data on their burden among adolescent mothers in Sub-Saharan Africa are limited. This study aimed to determine the prevalence of HDP and their association with birth outcomes among adolescent mothers at Livingstone University Teaching Hospital (LUTH) in Zambia.

METHODS

We conducted a retrospective cross-sectional study of 405 medical records of adolescent pregnancies (aged 10-19 years) at LUTH from January 2023 to December 2024. HDP was defined as systolic/diastolic blood pressure ≥ 140/90 mmHg after 20 weeks of gestation. Data were abstracted using REDCap and analyzed with StatCrunch. Univariable and multivariable logistic regression identified factors associated with HDP. Bivariate analyses examined associations with birth outcomes. Statistical significance was set at p < 0.05.

RESULTS

The prevalence of HDP was 16.8% (68/405). In multivariable analysis, increasing age (AOR = 1.31 per year, 95% CI: 1.06-1.63, p = 0.012), a previous history of hypertension (AOR = 1.77, 95% CI: 1.19-2.62, p = 0.005), and a positive family history of chronic hypertension (AOR = 3.89, 95% CI: 1.03-14.61, p = 0.044) were independent predictors. HDP was significantly associated with adverse birth outcomes (p = 0.014), particularly fetal death (46.2% vs. 16.1% among normotensive). Hypertensive adolescents had higher rates of preeclampsia (86.4% vs. 12.8%, p < 0.001), eclampsia (100% vs. 16%, p < 0.001), and fetal complications, including asphyxia (34.5% vs. 14.6%, p = 0.013) and prematurity (23.5% vs. 14.6%).

CONCLUSIONS

HDP affect nearly one in six adolescent mothers at a Zambian tertiary hospital and are strongly associated with adverse birth outcomes. Older age, prior hypertension, and family history of chronic hypertension are independent predictors. Enhanced antenatal risk assessment, including detailed personal and family history, age-stratified monitoring, and routine proteinuria screening, is urgently needed to improve maternal and neonatal outcomes in this high-risk population.