Factors related to blood pressure assessment during pregnancy in Ethiopia: Multilevel analysis using the 2019 mini demographic and health survey data.

Introduction: Blood pressure assessment is an essential strategy for early detection and treatment of hypertension and hypotension. Hypertensive disorders of pregnancy (HDP) are major public health problems resulting in a significant burden of perinatal and maternal morbidity and mortality. In Ethiopia, among pregnancies complicated by HDP, 25% end up with perinatal death. Perinatal and maternal mortality related to HDP were found to be higher in Ethiopia compared to high-income and most of the low- and middle-income countries. Despite its importance, there is limited evidence on blood pressure assessment during pregnancy. Therefore, this study aimed to determine the prevalence of blood pressure assessment during pregnancy and its associated factors in Ethiopia.

Methods: This study was based on the 2019 Mini Ethiopian Demographic and Health Survey data. A total weighted sample of 2923 women who had a live birth five years before the survey were included and Stata version 16 software was used for statistical analysis. To identify associated factors, a multilevel robust Poisson regression model was fitted since the prevalence of blood pressure assessment was higher than 10%. Variables with p-value < 0.2 in the bi-variable analysis were exported to the multivariable analysis. In the multivariable analysis, the adjusted prevalence ratio with its 95% confidence interval was used to declare a statistically significant association.

Results: In Ethiopia, the prevalence of blood pressure assessment during pregnancy was 88.1% (95% CI: 86.9%, 89.2%). In the multivariable multilevel robust Poisson analysis, primary education and secondary education, grand-multiparity, initiation of antenatal care before three months and 3-6 months, four and above antenatal care visits, being counselled by a health professional, being from richer and richest households, residing in Afar and Amhara regions were significantly associated with BP assessment during pregnancy in Ethiopia.

Conclusion And Recommendations: To reduce the high burden of mortality related to hypertensive disorders of pregnancy in the country, blood pressure assessment should be improved. Therefore, policymakers should design interventions that empower women in terms of education and economy, promoting early initiation of antenatal care visits and prenatal counselling could improve blood pressure assessment.