Antenatal care and its effect on risk of pregnancy induced hypertension in Lao PDR: A case-control study

Background: Pregnancy induced hypertension (PIH) is a global public health concern as a leading cause of maternal mortality. Lao PDR has a high prevalence of PIH, but little is known about its risk factors. This study aimed to identify risk factors of PIH relating to antenatal care (ANC) in Lao PDR. Methods: This hospital-based age-matched case control study was carried out between July and December 2017 in tertiary and secondary hospitals in Lao PDR. A total of 258 pregnant women (86 hypertensive and 172 normotensive pregnant women) were recruited to join the study based specific inclusion criteria. For each case, two consecutive controls were included in the study with matched maternal age. Data was collected using a structured questionnaire interview to identify the risk factors of PIH relating to ANC. The association between the independent variables and PIH was assessed through bivariable and conditional multiple logistic regression analyses. Results:  Mothers with PIH had inadequate ANC (defined as 13kg) ( adj. OR=7.35, 95%CI: 3.06 -17.69, p<0.001), had a history of abortion (adj. OR=3.54, 95%CI: 1.30-9.59, p=0.013), and had received inadequate information about PIH (adj OR= 2.58 , 95%CI: 1.03 – 6.46 , p=0.043). Conclusion:  Inadequate ANC and maternal factors were major risk factors of PIH in Lao PR. National PIH guidelines for effective counseling, ANC and treatment should be promptly developed and implemented at all levels in order to improve pregnancy outcomes.