Dietary Patterns and Hypertensive Disorders Among Pregnant Women Attending Antenatal and Delivery Care in Public Hospitals of Jimma Zone, Southwest Ethiopia

Abstract

Purpose

Hypertensive disorders of pregnancy are a major contributor to maternal morbidity and mortality. Dietary pattern is one of the modifiable determinants of hypertension. However, there is a research gap on dietary patterns and hypertensive disorders among pregnant women in Ethiopia. Therefore, this study aimed to identify dietary pattern of hypertensive disorders of pregnant women attending antenatal and delivery care.

Methods

Institution-based unmatched case control study was conducted among a total of 333 participants (111 cases and 222 controls). Data were collected using an interviewer administered questionnaire and analyzed using SPSS version 20. Principal component analysis was used to identify wealth tertile and cluster analysis was used to derive dietary pattern. Adjusted odds ratio with 95% confidence interval and variables with P-value <0.05 were declared as statistically significant. Model of fitness was tested using Hosmer–Lemeshow goodness-of-fit test.

Results

On multivariable analysis, plant source food based dietary pattern [AOR=0.36 95% CI: 0.15–0.82], balanced type of dietary pattern [AOR=0.24 95% CI: 0.11–0.51] and folate intake [AOR=0.17 95% CI: 0.06–0.48] were found to be significant protective factors from hypertensive disorders of pregnancy. Previous history of pregnancy induced hypertension [AOR=3.76 95% CI: 1.67–8.37], twin pregnancy [AOR=3.69 95% CI: 1.52–8.96], history of abortion [AOR=2.37 95% CI: 1.10–5.12], presence of anemia at the first visit [AOR=7.12 95% CI:2.30–21.98], gestational diabetes [AOR=3.12 95% CI: 1.002–9.72] and highest wealth index [AOR=4.17 95% CI: 1.27–13.66] were found to be significant risk factors for hypertensive disorders during pregnancy.

Conclusion

Balanced food based dietary pattern and plant-based food pattern had direct protective relationship with development of hypertension during pregnancy. This implies the need for promoting consumption of balanced diets and plant source foods high in fruit and vegetables. Mothers with twin pregnancies, anemia at first visit, previous history of pregnancy induced hypertension, and advanced age groups should be prioritized.

Keywords:

• dietary pattern
• hypertensive disorders
• Ethiopia
• pregnant women

Abbreviations

AOR, Adjusted odds ratio; CI, Confidence intervals; COR, Crude odds ratio; HDP, Hypertensive disorders of pregnancy; MNCH, Maternal, Newborn and Child Health.

Data Sharing Statement

The dataset for the current study is available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

The ethical review board of Jimma University approved the study and adhered to the declaration of Helsinki. The participants gave written informed consent to be enrolled in the study after they received an adequate briefing on the purpose and procedure of the study. The anonymity of all participating women was ensured by not recording any names or other personal identifiers. Their right not to participate, not to answer any or all questions and to withdraw from the interview at any time they want was respected.

Acknowledgments

The authors would like to extend their gratitude to the study participants for their consensual participation. Likewise, the authors would like to thank data collectors and supervisors for their commitment throughout the data collection process.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest in relation to this work.

Additional information

Funding

The authors received no funding from an external source.