The purpose of this study was to assess the knowledge, perceptions and practices of pregnant women regarding gestational hypertension.
Summary of Findings
The majority of the 266 participants were within the 20- to 30-year age range, had a tertiary education, were married, self-employed, earned a monthly income between 20,000 and 50,000 Naira, were primarily in the second or third trimester of pregnancy, had 2–4 parities, attended 1–3 antenatal care visits, and had not been previously diagnosed with GH. Tables 2 and 3 present a diverse spectrum of practices and perceptions of GH. While a notable proportion acknowledged the prevention of GH and endorsed preventative measures, there were disconcerting trends, such as resorting to self-medication and consulting traditional healers.
Participants reported high blood pressure, headaches, reduced fetal movement and blurred vision as the main signs of gestational hypertension. Most of the participants preferred to go to hospitals/clinics whenever they experienced various symptoms, such as headaches and abdominal pain. This good practice of going to the hospital first could be related to the participants’ basic knowledge of gestational hypertension and positive perceptions of gestational hypertension. Most of the women included in the present study had regular antenatal care visits. They ensured that they visited the hospital on their booked dates and whenever they experienced any form of discomfort. Antenatal care services provide the opportunity to educate pregnant women on pregnancy complications. Inadequate knowledge and negative perceptions and a lack of preventive practices for pregnant women who have strong traditional beliefs are major hindrances to efforts at reducing maternal mortality.8
These findings resonate with the literature, suggesting that younger pregnant women and those with higher education levels often have more positive perceptions of GH prevention.7 However, the prevalence of self-medication and traditional healers observed in this study exceeds findings reported by Johnson et al. (2017), underscoring the urgency for targeted interventions to cultivate healthcare-seeking behaviors among pregnant women within this demographic.9 A striking feature common to pregnant women is the belief that gestational hypertension can be prevented, and a greater number of them agreed that they could have gestational hypertension. With regard to multiple pregnancies causing gestational hypertension, more than half of the pregnant women disagreed that it was able to cause gestational hypertension. The majority of the pregnant women agreed strongly that gestational hypertension can be prevented. They also believe that continuous monitoring of mothers and children can prevent gestational hypertension, regular antenatal checks can prevent gestational hypertension, regular antenatal care aids early detection and prompt management, and maintaining an ideal weight can reduce the risk for gestational hypertension.10 The relationship between mothers’ gestational hypertension practices and the demographic characteristics of the respondents showed a significant association between mothers’ gestational hypertension practices and their level of education. This finding implies that the more educated (tertiary education) a person is, the more poor the practice, which is the same for secondary education and the least education (primary education).
Gestational hypertension constitutes 14% of maternal mortality in developing countries because in its early stage, a woman may be unaware of its presence, and maternal mortality rates have been associated with poor pregnancy-related hypertension knowledge, such as gestational hypertension, poor perception, and a lack of preventative practices among pregnant women burdened by traditional and cultural beliefs.11,12 This particular study revealed that there is poor knowledge, a lack of good practices and a positive perception of pregnant women toward gestational hypertension in Nsukka, Enugu State. This relatively high percentage of poor knowledge might be due to Nsukka being considered a semiurban community with little understanding of this condition of gestational hypertension among pregnant women attending antenatal care visits; this percentage could also be due to their educational background. Contrary to a previous study, the level of good knowledge on gestational hypertension among women in selected hospitals in Ghana was 118 (28.8%). Our findings are lower than those of a study conducted in Ghana.12 The discrepancy might be related to the variations between the scopes of the studies of preeclampsia in general and our study of gestational hypertension. Similarly, the variation in the measurement of the outcome variable might be the reason for the discrepancy. However, for people with a high level of education who are tertiary and have poor practices, having adequate knowledge does not mean having good practices or practicing the right thing.8,11 With regard to the practice of treating gestational hypertension, most of the study participants reported poor practices in terms of risk factors, prevention, signs, and symptoms of gestational hypertension. A similar finding was reported in a study conducted in Naples, Italy, which reported that only 21.7% of the study participants were worried about pregnancy risk factors.12 In this study, the majority of the participants had a positive perception of gestational hypertension.
The relationship between mothers’ practices related to gestational hypertension and the demographic characteristics of the respondents showed a significant association between mothers’ practices related to gestational hypertension and their level of education. The relationship between mothers’ perceptions of gestational hypertension and the demographic characteristics of the respondents showed a significant association between mothers’ perceptions of gestational hypertension and their level of education, occupation, gestational age, and parity. There are still many gaps in the knowledge of gestational hypertension. Gestational hypertension should be treated not only as a maternal and perinatal health problem but also as a health problem affecting later life. Early prediction using various risk factors, prevention through appropriate interventions and long follow-up for women with a history of HDP are important.13,14
Limitations of the study
This study had some limitations that should be considered when interpreting its findings. A major limitation of a cross-sectional questionnaire-based study such as this one is that the respondents’ answers may not be a true reflection of what they have in mind or what they want because some of them cannot read and write, and for some who can read and write, they do not have the strength to do that at the moment. Therefore, some of them answered questionnaires such as an interview question.
The study, which was also carried out only in Nsukka, does not provide enough representation of the views of pregnant women in Enugu State or Nigeria as a whole, although the Nsukka community is a metropolis with a mixed population of pregnant women from various educational backgrounds, social statuses, and ethnic groups.