Determinants of uncontrolled blood pressure among preeclamptic women receiving antihypertensive therapy in the South Gondar Zone, Northwest Ethiopia.

OBJECTIVES

To identify factors associated with uncontrolled blood pressure (BP) in preeclamptic women receiving antihypertensive therapy in the South Gondar Zone, Northwest Ethiopia.

STUDY

DESIGN

An unmatched case-control study was conducted using 288 preeclamptic women, including 96 cases (having uncontrolled BP) and 192 controls (with controlled BP).

MAIN OUTCOME MEASURES: The main outcomes were factors associated with uncontrolled BP in preeclamptic women receiving antihypertensive therapy. Binary logistic regression was used to identify factors associated with uncontrolled BP. Variables with p < 0.20 in bivariable analysis were entered into a multivariable model. Adjusted odds ratios (AORs) with 95 % confidence intervals (CIs) were used to measure strength of association and statistically significance was set at p < 0.05.

RESULTS

Uncontrolled BP was significantly associated with early-onset preeclampsia (AOR = 2.85; 95 % CI: 1.24-6.51), gestational diabetes mellitus (AOR = 4.03; 95 % CI: 1.26-12.85), interpregnancy interval ≤ 23 months (AOR = 3.84; 95 % CI: 1.10-13.36), body mass index (BMI) ≥ 30 kg/m2 (AOR = 5.35; 95 % CI: 1.16-24.55), and delayed initiation of antihypertensive treatment (AOR = 3.82; 95 % CI: 1.38-10.57).

CONCLUSIONS

Early-onset preeclampsia, gestational diabetes, short interpregnancy intervals, high BMI, and delayed treatment initiation were significantly associated with uncontrolled BP in preeclamptic women. Targeted interventions, including early diagnosis, prompt therapy initiation, counseling on healthy weight, and adequate pregnancy spacing, are recommended to improve blood pressure control and maternal outcomes.