TITLE:
The Use of Hormonal Contraceptives and Preeclampsia among Ghanaian Pregnant Women
AUTHORS:
Listowell Asare, George A. Asare, William K. B. A. Owiredu, Christian Obikorang, Efua Appiah, Worlanyo Tashie, Leila Seidu
KEYWORDS:
Preeclampsia, Hormonal Contraceptives, Depot Medroxyprogesterone Acetate
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.4,
April
25,
2021
ABSTRACT: Hormonal
contraceptives (HC) are thought to play a role in the pathogenesis of
cardiovascular diseases. The study evaluated the use of HC as a primary cause of preeclampsia (PE) among Ghanaians. This
study comprised 30 preeclamptic women
and 30 healthy normotensive pregnant women with over 20 weeks of
gestation at the Comboni Hospital, Ghana using a randomized case-control study. Blood pressure, weight,
height, socio-demographics, medical and previous obstetric history were taken
and recorded. Blood samples were collected for the estimation of homocysteine
and fasting lipids. Estimated foetal weight (EFW) and infant birthweight (BWT)
were obtained from maternal records. This study was carried out in 2019. 80.0%
of women with PE used the hormonal contraceptive “depot medroxyprogesterone
acetate” (DMPA) prior to pregnancy. The use of DMPA was associated with about
thirty-fold increase in the odds of developing PE (OR = 29.71, p 0.001). Systolic blood pressure (P 0.001), diastolic blood pressure (P 0.001), triglycerides (P = 0.024),
LDL-C (P = 0.026), and homocysteine
levels (P 0.001) were significantly
elevated in the PE cases than the normal pregnant (NP) women, whilst EFW (P 0.001), BWT (P 0.001)
and HDL-C levels (P = 0.001) were significantly
reduced in the PE cases when compared to NP women. 50% and 47% of PE cases had
intrauterine growth restriction and low birthweight infants, respectively. In
conclusion, DMPA use predisposes women to a high risk of developing PE. DMPA
could partly contribute to endothelial dysfunction, hyperhomocysteinaemia,
dyslipidaemia and excessive weight gain, all of which characterize PE.