Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study.
Birth asphyxia
Elevated blood pressure
Obstructed labour
Pediatric hypertension
Uganda
Journal
Clinical hypertension
ISSN: 2056-5909
Titre abrégé: Clin Hypertens
Pays: England
ID NLM: 101669508
Informations de publication
Date de publication:
01 Feb 2024
01 Feb 2024
Historique:
received:
05
07
2023
accepted:
24
12
2023
medline:
1
2
2024
pubmed:
1
2
2024
entrez:
31
1
2024
Statut:
epublish
Résumé
Globally, high systolic blood pressure accounts for 10.8 million deaths annually. The deaths are disproportionately higher among black people. The reasons for this disparity are poorly understood, but could include a high burden of perinatal insults such as birth asphyxia. Therefore, we aimed to assess the incidence of elevated blood pressure and to explore associated factors among children born to women with obstructed labour. We followed up children born to women with obstructed labour aged 25 to 44 months at Mbale regional referral hospital that had participated in the sodium bicarbonate trial ( Trial registration number PACTR201805003364421) between October 2021 and April 2022. Our primary outcome was elevated blood pressure defined as blood pressure (either systolic or diastolic or both) ≥ the 90th percentile for age, height, and sex in the reference population based on the clinical practice guideline for screening and management of high blood pressure in children and adolescents. We used logistic regression to estimate odds ratios between selected exposures and elevated blood pressure. The incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.6-36.1)). Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (Adjusted odds ratio (AOR) 2.46: 95% CI (1.01-5.97). Female participants had 2.81 times the odds of elevated blood pressure as their male counterparts (AOR 2.81 95% CI (1.16-6.82). Participants with reduced estimated glomerular filtration rate had 2.85 times the odds of having elevated blood pressure as those with normal estimated glomerular filtration rate (AOR 2.85 95% CI (1.00-8.13). We found no association between arterial cord lactate, stunting, wealth index, exclusive breastfeeding, food diversity and elevated blood pressure. Our findings show a high incidence of elevated blood pressure among children. We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors.
Sections du résumé
BACKGROUND
BACKGROUND
Globally, high systolic blood pressure accounts for 10.8 million deaths annually. The deaths are disproportionately higher among black people. The reasons for this disparity are poorly understood, but could include a high burden of perinatal insults such as birth asphyxia. Therefore, we aimed to assess the incidence of elevated blood pressure and to explore associated factors among children born to women with obstructed labour.
METHODS
METHODS
We followed up children born to women with obstructed labour aged 25 to 44 months at Mbale regional referral hospital that had participated in the sodium bicarbonate trial ( Trial registration number PACTR201805003364421) between October 2021 and April 2022. Our primary outcome was elevated blood pressure defined as blood pressure (either systolic or diastolic or both) ≥ the 90th percentile for age, height, and sex in the reference population based on the clinical practice guideline for screening and management of high blood pressure in children and adolescents. We used logistic regression to estimate odds ratios between selected exposures and elevated blood pressure.
RESULTS
RESULTS
The incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.6-36.1)). Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (Adjusted odds ratio (AOR) 2.46: 95% CI (1.01-5.97). Female participants had 2.81 times the odds of elevated blood pressure as their male counterparts (AOR 2.81 95% CI (1.16-6.82). Participants with reduced estimated glomerular filtration rate had 2.85 times the odds of having elevated blood pressure as those with normal estimated glomerular filtration rate (AOR 2.85 95% CI (1.00-8.13). We found no association between arterial cord lactate, stunting, wealth index, exclusive breastfeeding, food diversity and elevated blood pressure.
CONCLUSION
CONCLUSIONS
Our findings show a high incidence of elevated blood pressure among children. We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors.
Identifiants
pubmed: 38297357
doi: 10.1186/s40885-023-00261-6
pii: 10.1186/s40885-023-00261-6
doi:
Types de publication
Journal Article
Langues
eng
Pagination
4Subventions
Organisme : FIC NIH HHS
ID : 1R25TW011213
Pays : United States
Informations de copyright
© 2024. The Author(s).
Références
Nyirenda MJ. Non-communicable diseases in sub-Saharan Africa: understanding the drivers of the epidemic to inform intervention strategies. Int Health. 2016;8(3):157–8.
pubmed: 27178673
doi: 10.1093/inthealth/ihw021
Gouda HN, Charlson F, Sorsdahl K, Ahmadzada S, Ferrari AJ, Erskine H, et al. Burden of non-communicable diseases in sub-Saharan Africa, 1990–2017: results from the Global Burden of Disease Study 2017. Lancet Glob Health. 2019;7(10):e1375–87.
pubmed: 31537368
doi: 10.1016/S2214-109X(19)30374-2
GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1223–49.
Organization WH. A global brief on hypertension World Health Organization; 2013. Contract No.: WHO/DCO/WHD/2013.2.
Nakiriba R, Mayega RW, Piloya T, Nabukeera-Barungi N, Idro R. Prevalence and factors associated with dysglycemia among girls in selected boarding secondary schools in Wakiso District, Uganda. Adolesc Health Med Ther. 2018;9:167–76.
pubmed: 30464672
pmcid: 6211585
Kansiime S, Webb EL, Kusemererwa S, Lule SA, Niwaha AJ, Seeley J, et al. Blood pressure levels among children in rural Uganda: results from 1913 children in a general population survey. J Hum Hypertens. 2022;36(11):1021–6.
pubmed: 34537817
doi: 10.1038/s41371-021-00610-8
Sorof J, Daniels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension. 2002;40(4):441–7.
pubmed: 12364344
doi: 10.1161/01.HYP.0000032940.33466.12
Lande MB, Flynn JT. Treatment of hypertension in children and adolescents. Pediatr Nephrol. 2009;24:1939–49.
pubmed: 17690916
pmcid: 2756388
doi: 10.1007/s00467-007-0573-4
Polglase GR, Ong T, Hillman NH. Cardiovascular Alterations and Multiorgan Dysfunction After Birth Asphyxia. Clin Perinatol. 2016;43(3):469–83.
pubmed: 27524448
pmcid: 4988334
doi: 10.1016/j.clp.2016.04.006
Fellman V, Raivio KO. Reperfusion Injury as the Mechanism of Brain Damage after Perinatal Asphyxia. Pediatr Res. 1997;41(5):599–606.
pubmed: 9128279
doi: 10.1203/00006450-199705000-00001
Schutte AE, Botha S, Fourie CMT, Gafane-Matemane LF, Kruger R, Lammertyn L, et al. Recent advances in understanding hypertension development in sub-Saharan Africa. J Hum Hypertens. 2017;31(8):491–500.
pubmed: 28332510
doi: 10.1038/jhh.2017.18
Roszkowska-Blaim M, Skrzypczyk P. Hypertension in children with end-stage renal disease. Adv Med Sci. 2015;60(2):342–8.
pubmed: 26275711
doi: 10.1016/j.advms.2015.07.001
Musaba MW, Ndeezi G, Barageine JK, Weeks A, Nankabirwa V, Wamono F, et al. Risk factors for obstructed labour in Eastern Uganda: A case control study. PLoS ONE. 2020;15(2):e0228856.
pubmed: 32040542
pmcid: 7010384
doi: 10.1371/journal.pone.0228856
Musaba MW, Barageine JK, Ndeezi G, Wandabwa JN, Weeks A. Effect of preoperative bicarbonate infusion on maternal and perinatal outcomes of obstructed labour in Mbale Regional Referral Hospital: a study protocol for a randomised controlled trial. BMJ Open. 2019;9(4):e026675.
pubmed: 31048444
pmcid: 6502014
doi: 10.1136/bmjopen-2018-026675
Musaba MW, Wandabwa JN, Ndeezi G, Weeks AD, Mukunya D, Waako P, et al. Effect of pre-operative bicarbonate infusion on maternal and perinatal outcomes among women with obstructed labour in Mbale hospital: A double blind randomized controlled trial. PLoS ONE. 2021;16(2):e0245989.
pubmed: 33561141
pmcid: 7872290
doi: 10.1371/journal.pone.0245989
Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, et al. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017;140(3):e20171904. https://doi.org/10.1542/peds.2017-1904 .
Chebet M, Musaba MW, Mukunya D, Makoko B, Napyo A, Nantale R, et al. High Burden of Neurodevelopmental Delay among Children Born to Women with Obstructed Labour in Eastern Uganda: A Cohort Study. Int J Environ Res Public Health. 2023;20(4):3470.
pubmed: 36834165
pmcid: 9963417
doi: 10.3390/ijerph20043470
Chebet M, Musaba MW, Mukunya D, Makoko B, Napyo A, Nantale R, et al. High Burden of Neurodevelopmental Delay among Children Born to Women with Obstructed Labour in Eastern Uganda: A Cohort Study. Int J Environ Res Public Health. 2023;20(4). https://doi.org/10.3390/ijerph20043470
Noubiap JJ, Essouma M, Bigna JJ, Jingi AM, Aminde LN, Nansseu JR. Prevalence of elevated blood pressure in children and adolescents in Africa: a systematic review and meta-analysis. Lancet Public Health. 2017;2(8):e375–86.
pubmed: 29253478
doi: 10.1016/S2468-2667(17)30123-8
Afaa TJ, NA HS, Ameyaw E, Rodrigues OP. Blood pressure profile, prevalence of hypertension and associated familial factors in school children in Accra Ghana. Niger J Clin Pract. 2022;25(4):386–90.
pubmed: 35439894
doi: 10.4103/njcp.njcp_1832_21
Ejike C. Prevalence of Hypertension in Nigerian Children and Adolescents: A Systematic Review and Trend Analysis of Data from the Past Four Decades. J Trop Pediatr. 2017;63(3):229–41.
pubmed: 28082664
Holzmann M, Cnattingius S, Nordström L. Lactate production as a response to intrapartum hypoxia in the growth-restricted fetus. BJOG. 2012;119(10):1265–9.
pubmed: 22804901
doi: 10.1111/j.1471-0528.2012.03432.x
Sungwa EE, Kibona SE, Dika HI, Laisser RM, Gemuhay HM, Kabalimu TK, et al. Prevalence and factors that are associated with elevated blood pressure among primary school children in Mwanza Region. Tanzania Pan Afr Med J. 2020;37:283.
pubmed: 33654510
Muhihi AJ, Njelekela MA, Mpembeni RNM, Muhihi BG, Anaeli A, Chillo O, et al. Elevated blood pressure among primary school children in Dar es salaam, Tanzania: prevalence and risk factors. BMC Pediatr. 2018;18(1):54.
pubmed: 29433455
pmcid: 5809963
doi: 10.1186/s12887-018-1052-8
Goon D, Amusa L, Mhlongo D, Khoza L, Anyanwu F. Elevated Blood Pressure among Rural South African Children in Thohoyandou South Africa. Iran J Public Health. 2013;42(5):489–96.
pubmed: 23802106
pmcid: 3684457
Gomwe H, Seekoe E, Lyoka P, Marange CS. Blood pressure profile of primary school children in Eastern Cape province, South Africa: prevalence and risk factors. BMC Pediatr. 2022;22(1):207.
pubmed: 35421965
pmcid: 9009017
doi: 10.1186/s12887-022-03221-5
Lee HA, Park B, Park EA, Cho SJ, Kim HS, Choi EJ, et al. Blood Pressure Curve for Children Less than 10 Years of Age: Findings from the Ewha Birth and Growth Cohort Study. J Korean Med Sci. 2020;35(12):e91.
pubmed: 32233160
pmcid: 7105512
doi: 10.3346/jkms.2020.35.e91
Alvarez J, Aguilar F, Lurbe E. Blood pressure measurement in children and adolescents: key element in the evaluation of arterial hypertension. An Pediatr (Engl Ed). 2022;96(6):536 e1-e7.
pubmed: 35659490
Wirix AJ, Nauta J, Groothoff JW, Rabelink TJ, HiraSing RA, Chinapaw MJ, et al. Is the prevalence of hypertension in overweight children overestimated? Arch Dis Child. 2016;101(11):998–1003.
pubmed: 27045117
doi: 10.1136/archdischild-2015-309969
Berenson GS. Childhood risk factors predict adult risk associated with subclinical cardiovascular disease: The Bogalusa Heart Study. Am J Cardiol. 2002;90(10, Supplement 3):L3–7.
doi: 10.1016/S0002-9149(02)02953-3
Chiolero A, Madeleine G, Gabriel A, Burnier M, Paccaud F, Bovet P. Prevalence of elevated blood pressure and association with overweight in children of a rapidly developing country. J Hum Hypertens. 2007;21(2):120–7.
pubmed: 17136104
doi: 10.1038/sj.jhh.1002125
Ujunwa FA, Ikefuna AN, Nwokocha AR, Chinawa JM. Hypertension and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria. Ital J Pediatr. 2013;39:1–6.
doi: 10.1186/1824-7288-39-70
Genovesi S, Giussani M, Pieruzzi F, Vigorita F, Arcovio C, Cavuto S, et al. Results of blood pressure screening in a population of school-aged children in the province of Milan: role of overweight. J Hypertens. 2005;23(3):493–7.
pubmed: 15716688
doi: 10.1097/01.hjh.0000160203.35910.9f
Fuiano N, Luciano A, Pilotto L, Pietrobelli A. Overweight and hypertension: longitudinal study in school-aged children. Minerva Pediatr. 2006;58(5):451–9.
pubmed: 17008856
Mahyar A, Ebrahemi M, Shahsavari A, Rahmani Y. Blood pressure of primary-school children of Eghbalieh city, Islamic Republic of Iran. East Mediterr Health J. 2009;15(6):1449–54.
pubmed: 20218137
Sukhonthachit P, Aekplakorn W, Hudthagosol C, Sirikulchayanonta C. The association between obesity and blood pressure in Thai public school children. BMC Public Health. 2014;14:729.
pubmed: 25034700
pmcid: 4223408
doi: 10.1186/1471-2458-14-729
Zhang YX, Wang SR. Comparison of blood pressure levels among children and adolescents with different body mass index and waist circumference: study in a large sample in Shandong. China Eur J Nutr. 2014;53(2):627–34.
pubmed: 23917448
doi: 10.1007/s00394-013-0571-1
Also U, Asani M, Ibrahim M. Prevalence of elevated blood pressure among primary school children in Kano Metropolis Nigeria. Nigerian J Cardiol. 2016;13(1):57–61.
doi: 10.4103/0189-7969.165167
Abir-Khalil S, Zaîmi S, Tazi MA, Bendahmane S, Bensaoud O, Benomar M. Prevalence and predictors of white-coat hypertension in a large database of ambulatory blood pressure monitoring. East Mediterr Health J. 2009;15(2):400–7.
pubmed: 19554987
doi: 10.26719/2009.15.2.400
Fisher M, Blackwell J, Saseen J. Clinical inquiries. What is the best way to identify patients with white-coat hypertension? J Fam Pract. 2005;54(6):549–5052.
pubmed: 15939009
Mushengezi B, Chillo P. Association between body fat composition and blood pressure level among secondary school adolescents in Dar es Salaam. Tanzania Pan Afr Med J. 2014;19:327.
pubmed: 25918567
Shah P, Riphagen S, Beyene J, Perlman M. Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischaemic encephalopathy. Arch Dis Child Fetal Neonatal Ed. 2004;89(2):F152–5.
pubmed: 14977901
pmcid: 1756028
doi: 10.1136/adc.2002.023093
Gopal G. Acute Kidney Injury (AKI) in perinatal asphyxia. Indian J Pharm Biol Res. 2014;2(2):60.
doi: 10.30750/ijpbr.2.2.11
Jenik AG, CerianiCernadas JM, Gorenstein A, Ramirez JA, Vain N, Armadans M, et al. A randomized, double-blind, placebo-controlled trial of the effects of prophylactic theophylline on renal function in term neonates with perinatal asphyxia. Pediatrics. 2000;105(4):E45.
pubmed: 10742366
doi: 10.1542/peds.105.4.e45
Dauber IM, Krauss AN, Symchych PS, Auld PA. Renal failure following perinatal anoxia. J Pediatr. 1976;88(5):851–5.
pubmed: 1271150
doi: 10.1016/S0022-3476(76)81130-4
Roszkowska-Blaim M, Skrzypczyk P. Hypertension in children with end-stage renal disease. Adv Med Sci. 2015;60(2):342–8.
pubmed: 26275711
doi: 10.1016/j.advms.2015.07.001
Martin RM, Ness AR, Gunnell D, Emmett P, Smith GD. Does breast-feeding in infancy lower blood pressure in childhood? The Avon Longitudinal Study of Parents and Children (ALSPAC). Circulation. 2004;109(10):1259–66.
pubmed: 14993142
doi: 10.1161/01.CIR.0000118468.76447.CE
Martin RM, Gunnell D, Davey SG. Breastfeeding in infancy and blood pressure in later life: systematic review and meta-analysis. Am J Epidemiol. 2005;161(1):15–26.
pubmed: 15615909
doi: 10.1093/aje/kwh338
Miliku K, Moraes TJ, Becker AB, Mandhane PJ, Sears MR, Turvey SE, et al. Breastfeeding in the first days of life is associated with lower blood pressure at 3 years of age. J Am Heart Assoc. 2021;10(15):e019067.
pubmed: 34284597
pmcid: 8475685
doi: 10.1161/JAHA.120.019067