ArticleInternational journal of cardiology. Cardiovascular risk and prevention2026
Prevalence and risk factors of hypertensive disorders during pregnancy in Somalia: A multilevel analysis of the 2020 Demographic and Health Survey.
Article in International journal of cardiology. Cardiovascular risk and prevention, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hypertensive disorders of pregnancy (HDP) are significant contributors to maternal mortality, particularly in low-resource settings like Somalia. This study aimed to determine the prevalence of this condition during antenatal care (ANC) and identify associated risk factors among pregnant women in Somalia. Methods: This cross-sectional study analyzed data from 3034 women aged 15-49 years who had at least one ANC visit for their most recent live birth, using the 2020 Somalia Health and Demographic Survey (SHDS). Multilevel logistic regression was employed to identify associated individual and contextual factors. Results: The overall prevalence of reported HDP during ANC was 11.0%. In the adjusted multilevel model, factors significantly associated with of reported HDP included primary education (Adjusted Odds Ratio [AOR]: 0.62, 95% Confidence Interval [CI]: 0.43-0.90), secondary education (AOR: 0.39, 95% CI: 0.19-0.79), attending four or more ANC visits (AOR: 0.46, 95% CI: 0.31-0.69), and delivering in a health facility (AOR: 0.54, 95% CI: 0.41-0.71). Pronounced regional disparities were observed, with women in regions such as Banadir (AOR: 4.94, 95% CI: 2.36-10.32) reporting a significantly higher rate of HDP than those in the Awdal region. Conclusion: Findings reveal that women with higher education and more frequent ANC visits had lower odds of reporting HDP, a counterintuitive result that suggests complex underlying factors in diagnosis and reporting. Urgent, targeted interventions are imperative to address regional inequities and understand the drivers of HDP to improve maternal health outcomes.
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