Investigating Lifestyle Factors Associated with Hypertensive Disorders in Third Trimester Pregnant Women attending ANC Banadir Hospital, Mogadishu, Somalia
Author: Abdikarim Adan Osman
MPH in epidemiology and infectious control,
Email: cabdikarim63@gmail.com
Lecturer: Plasma University, Mogadishu Somalia
.
Abstract
This cross-sectional study aimed to establish the predisposing lifestyle factors to hypertensive disorders in third-trimester pregnant women attending Banadir Hospital, Mogadishu, Somalia. Since hypertensive disorders are very common during pregnancy, especially among high-risk women with modifiable lifestyle factors this study intended to determine the relationship between certain lifestyles and hypertension risk among pregnant women. With the help of the structured questionnaires, information from 171 subjects was collected. Chi-square tests were conducted to identify the significance of the selected factors, such as diet, physical activity, use of substances, and stress, as potential risk factors for hypertension. Therefore, the study reemphasizes the need for interventions for high-risk individuals in this setting. The study shows an alarming correlation between some aspects of life and hypertension disorders. For example, while 18.6% of women who used red meat more than twice per week were hypertensive, 15.5% of those who rarely used red meat were hypertensive; a difference statistically significant at a chi-square value of 7.64 (p=0.022) indicating increased cardiovascular risks with use of high red meat. Also, there was a significant correlation between smoking and hypertension; 47% of smokers had hypertensive disorders against 29.4% of non-smokers (χ²=8.43, p<0.004). Nonetheless, the study did not establish a relationship between processed meat consumption and hypertensive disorders because 49.4% of the participants reported frequent consumption of processed meat without increased hypertension risk. Such findings highlight the dietary and lifestyle change approaches in managing hypertension in pregnant women. Stress also came out as an important variable; 30.5% mentioned work as one of the main causes of stress related to hypertensive results (χ²=6.68, p=0.035). Moderate physical activity and fruits and vegetables interval appeared to have protective effects although 55.3% of participants were leading sedentary lifestyles which was not significant with hypertension, needs more structured physical activity. This means that there could be work-related stress and that the rates of sedentary work imply possible areas of focus on healthcare mother-related systems. From the study, there is an improved outlook to enhance dietary handling, smoking and stress management programs in Banadir Hospital for the patients in the groups created through checkups. Individualized and group interventions and education can play a role in reducing hypertension risks, which will improve Maternal Health among pregnant women. The outlined strategies have been suggested to be easily adapted to other comparable hospital environments thus providing a framework for effective hypertension intervention in maternal care.
Keywords: hypertensive disorders, pregnancy, lifestyle factors, Banadir Hospital, dietary habits, smoking, stress, physical activity.
1.0 INTRODUCTION
Hypertensive disorders of pregnancy (HDP) remain a major cause of maternal and fetal morbidity and mortality in developed and developing countries. These disorders include gestational hypertension; preeclampsia; eclampsia; and chronic hypertension, and they are more common in LMICs where there may be restricted access to healthcare services, and many women receive little prenatal care or education on lifestyle-related health risks (WHO, 2019). According to cross-sectional investigations, HDP impacts 10% of pregnancies worldwide, and the present research indicates that sub-Saharan Africa, including Somalia, has a higher incidence (Jiang et al.,2022). At present HDP is a major health concern in Somalia since these conditions can complicate pregnancy leading to preterm birth, low birth weight and maternal mortality. Also, HDP can have serious and chronic effects on the health of the mother at later stages of her life including chronic hypertension, cardiovascular diseases and kidney damage as noted by Khosla et al., (2021). Considering these risks, it is therefore important to identify and understand the lifestyle determinant of HDP and therefore inform efforts toward prevention and interventions to enhance women’s and neonates’ health within facilities such as Banadir Hospital in Mogadishu.
Hypertensive disorders in pregnancy are influenced greatly by lifestyle changes. They include; the type of food we take, whether we are active or not, and the amount of alcohol and cigarettes we take, since they all affect blood pressure and thus hypertension. For instance, various research proposed that excessive consumption of red and processed meats, foods that contain high amounts of sodium and saturated fats tends to raise blood pressure levels and increase the risk of hypertensive complications (Allen et al.,2022). On the other hand, a diet that contains fruits, vegetables, whole grain products, and low-fat dairy products indicates good blood pressure control and decreased risk of developing hypertension during pregnancy (Viggiano et al.,2023). Also, smoking and alcohol have been reckoned as common causes of hypertension since they can cause spasms of blood vessels and thus raise tension within the heart arteries and overall demand on the cardiovascular organ (Akhlaghi, 2020). The association between these lifestyles and HDP establishes the need to examine such factors more closely within the pregnancy population of Banadir Hospital to establish distinct regional influences on this mode of HDP.
Physical activity remains another essential factor in the treatment of hypertension and the prevention of hypertensive disorders in pregnancy. Ongoing physical exercise enhances the functioning of the heart, decreases stress, and results in a healthy weight which are all factors that enhance blood pressure (Park et al.,2020). Nevertheless, in other cultures, societies and economic situations like for example, Somalia cultural and economic constraints may hinder women from practising physical activities during pregnancy. Such barriers may include where and how pregnant women can access safe spaces to exercise; knowledge of exercising during pregnancy; and cultural and/or traditional practices that deny pregnant women the chance to exercise. Therefore, the characterized lifestyle puts pregnant women in Somalia at a risk of HDP, which may not be the same as that of other regions. Research conducted in a limited setting, particularly Banadir Hospital will establish the extent to which these factors impact HDP risk in the Somali setting which will benefit the development of socially appropriate health interventions and policies.
However, while controlling boosters and following diet and exercise regimes, stress has been known to play a major role in hypertension control as well. High stress has been also reported to raise levels of blood pressure that translate to an increased risk of hypertensive disorders; these can be socio-economic issues, or work or family stressors (Perez, 2021). In Somalia, the majority of pregnant women experience higher levels of stress because of issues like poverty, lack of access to medical services, and the difficulties of functioning in a society that has Wored 152 Reconstruction of Somalia after war experience (Taha, 2022). When stress is chronic, cortisol levels rise and deteriorate blood vessels further causing prehypertension. Concerning the particular socioeconomic and cultural context of Somalia, it became necessary to investigate the effects of stress and coping mechanisms of pregnant women in Banadir Hospital on HDP. It can help to address this aspect to find ways would reduce the risk of HDP and improve Maternal health in support and mental health services.
While concerns regarding lifestyle factors influencing hypertensive disorders exist in a global context, specifically among Somali women especially those living in Mogadishu there is little information. Considering the broadly different social, economic, cultural and health environments, situation in Somalia, it may be pertinent to launch investigations more focused on the potential behavioural determinants of HDP associated with Somalian women. This study aims to fill this gap by examining the lifestyle characteristics that follow hypertensive disorders among third-trimester pregnant women in Banadir Hospital, Mogadishu. As a result, the present study of selected lifestyle risk factors in this particular group was designed to fill this gap by pointing to the population at highest risk so that more relevant and targeted primary preventive efforts could be directed at them to promote healthy maternal and fetal outcomes in Somalia.
Aims
The aim of this study was therefore to determine the prevalence and risk factors for hypertensive disorders amongst third-trimester pregnant women at Banadir Hospital in Mogadishu, Somalia. In more detail, the study aimed to find out how many of these people had the relevant disorders and which activity, nutrition, and/or alcohol use were most closely linked to hypertension. Also, socio-economic factors operating during pregnancy, stress factors, and family-work-related pressure in the development of hypertensive disorders in pregnancy were analyzed.
2.0 THEORETICAL FRAMEWORK
This study’s theoretical framework is grounded in two key models that provide insight into the development and management of hypertensive disorders during pregnancy: The Health Belief Model (HBM) and the Mosaic Theory of Hypertension. These frameworks are chosen because they embrace learning about personal behaviours and also acknowledge that hypertension is a disease that has multiple factors and ways in which it affects pregnant women.
The Health Belief Model (HBM), which was designed to explain why a person adopts or does not adopt certain health-promoting or health-risking behaviours, is useful in investigating how pregnant women’s decision-making about their lifestyle is related to their beliefs about hypertension. HBM postulates that decisions on health-related behaviour are determined mainly by perceived susceptibility, perceived severity, perceived benefits and perceived barriers (Becker, 1974). Concerning hypertensive disorders in pregnancy, the HBM supports the notion that a pregnant woman is only likely to engage in preventive behaviours; including changes in dieting, exercising, and refraining from smoking and or taking alcohol, if she is informed of the dangers of hypertension during pregnancy and believes that those measures will work (Beressa et al., 2024). For instance, once a pregnant woman feels that she is prone to hypertension; and that such conditions can be dangerous, then she will be compelled to change her behavior and avoid the probable consequences. HBM is useful in analyzing the degree of awareness and beliefs associated with the lifestyle preferences of pregnant women in Banadir Hospital.
The Mosaic Theory of Hypertension was developed by the late Dr. Irvine Page who believed that hypertension was a total interdependence of genes, environment, physiology, diet, disease, and behaviour (Page, 1960). As per the same, hypertension is not a solitary resultant of any factor; instead, it has a ‘mosaic’ of triggers, including genes, the diet taken, the physical activities done and the stress being faced. The most useful theory to this study will be the Mosaic theory, as it explains hypertensive disorders in pregnancy in terms of lifestyle factors and socio-environmental factors, including socioeconomic status levels and stress. This recognises the roles of genetic components and other environmental factors and thus enhances the call for complex and multiple approaches towards management and prevention (Gurven et al.,2024). This framework assists in disseminating assessment of suitable changeable risk factors which can indeed predispose pregnant women to develop hypertensive disorders including recommended lifestyle changes like exercise and diet as well as other non-modifiable risk factors for example family history.
The combination of the Health Belief Model and the Mosaic Theory of Hypertension offers an integrated theoretical approach providing insight into the lifestyle, attitude, and environmental factors, which can elaborate the probability and control of hypertensive disorders in third-trimester pregnant women. These frameworks help inform how those factors operate, to provide understanding that might help enhance prevention and treatment for hypertensive disorders in pregnant women who are at risk.
3.0 METHODOLOGY
Research Design and Sampling
The study design adopted in this research was cross-sectional to estimate the point prevalence and sociodemographic and lifestyle factors of hypertensive disorders among third–trimester pregnant women attending Banadir Hospital in Mogadishu, Somalia. A cross-sectional observational study design was used, to give a clear snapshot of the relationship between lifestyle factors and hypertensive disorders as recommended for epidemiological research (Creswell, 2014). The target population comprised pregnant women in the third fetal trimester who visited Banadir Hospital for ANC services during data collection. Slovin’s formula was used to determine the sample to be 171 participants with a 5 percent margin of error as a way of guaranteeing enough power in the test. The purposive sampling method was used aimed at women with a risk or history of developing hypertensive disorders.
Inclusion Criteria: The target population included third-trimester pregnant women who came to receive antenatal care at Banadir Hospital, with a diagnosis of hypertensive disorders like preeclampsia or gestational hypertension, who agreed and volunteered and signed a consent form.
Exclusion Criteria: Voluntarily using women drug users were excluded because they presented with past or present drug use, mental health problems or were not willing to give consent for voluntary use were excluded minimizing confounding factors thus the sample comprised of women with primary research interest.
Data Collection Instruments and Procedure
In the study, both structured questionnaires and clinical assessment tools were used to collect data. The structured questionnaire was developed to cover four main areas: Components include; (1) socio-demographic data; (2) diet, smoking, and physical activity; (3) medical history and family history of hypertension; (4) perceived stress, and economic status. Program assessments included systolic and diastolic blood pressure; BMI; and fasting plasma glucose and cholesterol levels to determine an objective picture of hypertensive risk. Concerning validity, a small random sampling method was used involving participants from the target population to establish that the core questionnaire items were clear and adequate. The trained research assistants physically administered the structured and semi-structured interview questionnaires provided participants with information on the study objective and secured anonymity. With the consent of the subjects, assistants carried out the interviews with the prepared questions and conducted clinical tests. One advantage of integrating interview and assessment as the methods of data collection is that all aspects of the respondent were covered.
Data Analysis and Ethical Considerations
Quantitative data were analyzed using SPSS (Statistical Package for the Social Sciences) version 25. In terms of summary parameters: the mean, standard deviation, and frequency were used to analyze demographic and health characteristics. Chi-square tests and a logistic regression analysis were conducted in the study to determine the relationships of different lifestyles, that is dietary habits, smoking and physical activity with hypertensive disorders, after controlling for sociodemographic factors. The statistically significant level was chosen to be 0.05. This study was cleared by Mount Kenya University’s Institutional Ethics and Research Committee and Banadir Hospital administration. All the participants’ consent was sought, and their anonymity was protected. Participants were informed that they could participate in the study without compensation and their right to withdraw at any time without any impact on the quality of the medical treatment they receive was exercised in the study. This ethical approach helped to protect the participant’s rights needed during the study.
4.0 RESULTS
Lifestyle Factors Associated with Hypertensive Disorders
To identify the lifestyle factors predisposing pregnant women at Banadir Hospital, Mogadishu, Somalia to hypertensive disorders in the third trimester the paper performed the following analyses. This section gives a snapshot of other lifestyle behaviours such as food behaviours substance use and physical activities concerning hypertensive disorders during pregnancy. The study assessed the association of the variables and therefore we used chi-square tests to compare the results.
Table 1: Association of Lifestyle Factors with Hypertensive Disorders
| Factors/Variables | Overall | Control | Cases | χ² | p-value | Odds Ratio |
| How often do you eat red meat? | ? | |||||
| Never | 22 (12.9%) | 16 (18.8%) | 6 (7.1%) | 7.64 | 0.022 | 0.50 |
| Once per week | 42 (24.7%) | 27 (31.8%) | 15 (17.6%) | 1.20 | ||
| 1-2 times per week | 52 (30.6%) | 23 (27.0%) | 29 (34.1%) | 1.15 | ||
| More than twice per week | 54 (31.8%) | 19 (22.4%) | 35 (41.2%) | 1.60 | ||
| How often do you eat processed meat? | ||||||
| Never | 12 (7.1%) | 6 (7.1%) | 6 (7.1%) | 2.43 | 0.492 | 1.00 |
| Once per week | 18 (10.6%) | 8 (11.8%) | 10 (9.4%) | |||
| 1-2 times per week | 55 (32.9%) | 28 (31.8%) | 27 (34.1%) | |||
| More than twice per week | 85 (49.4%) | 43 (52.9%) | 42 (45.9%) | |||
| Currently smoking | ||||||
| Yes | 65 (38.2%) | 25 (29.4%) | 40 (47.1%) | 8.43 | 0.004 | 1.80 |
| No | 105 (61.8%) | 60 (70.6%) | 45 (52.9%) | |||
| Alcoholic beverage consumption | ||||||
| Yes | 105 (61.8%) | 53 (62.4%) | 52 (61.2%) | 0.12 | 0.733 | 1.00 |
| No | 65 (38.2%) | 32 (37.6%) | 33 (38.8%) | 0.95 | ||
| Drug intake | ||||||
| Yes | 15 (8.8%) | 8 (9.4%) | 7 (8.2%) | 0.11 | 0.741 | 1.10 |
| No | 155 (91.2%) | 77 (90.6%) | 78 (91.8%) | 0.90 | ||
| Consumption of fruits/vegetables | ||||||
| Every day | 74 (43.5%) | 39 (45.9%) | 35 (41.2%) | 0.80 | 0.671 | 1.00 |
| Once in a while if available | 94 (55.3%) | 45 (52.9%) | 49 (57.6%) | 1.10 | ||
| I don’t take any fruits/vegetables | 2 (1.2%) | 1 (1.2%) | 1 (1.2%) | 1.00 | ||
| Addition of salt to food served | ||||||
| Every meal | 101 (59.4%) | 51 (60.0%) | 50 (58.8%) | 0.15 | 0.929 | 1.00 |
| Once in a while | 44 (25.9%) | 23 (27.1%) | 21 (24.7%) | 0.95 | ||
| I don’t add | 25 (14.7%) | 11 (12.9%) | 14 (16.5%) | 1.20 | ||
| How often do you exercise | ||||||
| Always | 36 (21.2%) | 16 (18.8%) | 20 (23.5%) | 1.42 | 0.491 | 1.15 |
| Once in a while | 40 (23.5%) | 22 (25.9%) | 18 (21.2%) | 1.10 | ||
| Never | 94 (55.3%) | 47 (55.3%) | 47 (55.3%) | 1.00 | ||
| Time spent walking | ||||||
| Less than 30 minutes | 84 (49.4%) | 44 (51.8%) | 40 (47.1%) | 1.37 | 0.505 | 1.05 |
| 30-50 minutes | 46 (27.1%) | 27 (31.8%) | 19 (22.4%) | 0.85 | ||
| More than 50 minutes | 40 (23.5%) | 14 (16.4%) | 26 (30.5%) | 1.50 | ||
| Source of your stress | ||||||
| Office/job environment | 40 (23.5%) | 14 (16.4%) | 26 (30.5%) | 6.68 | 0.035 | 1.50 |
| Home | 46 (27.1%) | 27 (31.8%) | 19 (22.4%) | 0.80 | ||
| Partner | 84 (49.4%) | 44 (51.8%) | 40 (47.1%) | 1.10 | ||
| What most stresses you | ||||||
| Never | 84 (49.4%) | 44 (51.8%) | 40 (47.1%) | 3.51 | 0.173 | 1.00 |
| Sometimes | 40 (23.5%) | 14 (16.4%) | 26 (30.5%) | 1.20 | ||
| Very often | 46 (27.1%) | 27 (31.8%) | 19 (22.4%) | 0.85 |
Table 1 displays the correlation between several aspects of lifestyle and hypertensive disorders prevalence among the third-trimester pregnant women attending antenatal care at Banadir Hospital in Mogadishu Somalia. The p-value and Odds Ratio for each factor were calculated using the chi-square tests to know the statistical significance level of each factor for the hypertensive disorders.
Dietary Habits and Hypertension
Hypertensive disorders were significantly related to red meat intake with a calculated Chi-square value of 7.64 and p-value, of 0.022. Women who consumed red meat in proportions over twice a week had the highest odds ratio at 1.60 implying that higher consumption of red meat results in hypertension. This risk factor correlates with prior findings that raise blood pressure levels due to increased red meat consumption resulting from its content of saturated fats and cholesterol. However in the people with a negligible frequency of red meat consumption, the odds ratio was 0.50, meaning the risk of hypertension was low. They on the other hand did not find any statistical association with hypertension as regards consumption of processed meat (χ²=2.43, p=0.492) although the odds ratios were somewhat evenly distributed across the consumption categories. This may be due to differences in diet or manner of preparation of meats that are common in these groups and may influence hypertension among these people.
Smoking and Hypertension
The results of the analysis of the relationship between smoking and hypertensive disorders yielded a chi-square equaling 8.43 and 0.004 probability values. Out of the respondents, 47.1% of the smokers were in the hypertensive group implying that the odds ratio was 1.80 that is, smokers were 1.8 times more likely to be hypertensive than non-smokers. It is factual that smoking is a hypertensive factor due to the negative it has on arteries and the hypertension-causing ability it has on pregnant women.
Alcohol and Drug Intake
According to the findings, alcohol consumption was noted to be independent of hypertension (χ²=0.12, p> 0.05= 733). There was almost equality of alcohol consumption among the two groups as the OR was almost 1, thus no significant association. This can be attributed to differences in drinking habits or perceived acceptable amounts of alcohol taken in the population. Drug intake could not explain hypertension either (χ²=0.11, p=0.741) based on a near-perfect odds ratio of 1. This contrasts with other ENP studies, where medication use is associated with hypertension; the low reported usage, alongside possibly uncontrolled types, may have affected this outcome.
Consumption of Fruits, Vegetables, and Salt
Fruits and vegetable intake had an insignificantly low risk association with hypertensive disorders (χ²=0.80 p=0.671 OR) implying that neither frequent vegetable consumption nor infrequent vegetable consumption presented a graded risk of hypertensive disorders. Even though the consumption of fruits and vegetables is usually linked with a lower risk of cardiovascular diseases this feature might not necessarily prevent hypertension if the availability of these foods is rather unstable, their quality is low or if their variety is not sufficient. Likewise, the use of salt to cook or condiment food was not found to correlate with hypertension (chi-square = 0.15; p = 0.929). This is in contrast with earlier research done on salt and the effects it has on high blood pressure that could be largely a result of salt-sensitive or other dietary variations defining sodium intake in different regions.
Physical Activity
Similarly, exercise frequency and time spent walking also did not significantly correlate with hypertensive disorders. Again, most patients were almost sedentary with no difference in hypertension risk among those who exercised regularly and those who exercised rarely or not at all (χ²=1.42, p=0.491). As with other activities, no significant association was observed between walking at any duration and hypertension (χ²=1.37, p=0.505). These findings imply that doing physical activity by itself may not powerfully affect hypertension in this population, and other factors such as intensity or exaggeration of the activity of the exercise may be in play.
Stress and Hypertension
Stress was found to be among the important lifestyle determinants of hypertension. Those who selected work-related stress as one of the most significant sources were likely to have hypertension (χ²=6.68, p=0.035), OR=1.50 suggesting a 50% chance higher than participants who did not report work-related stress. Work-related stress is known to increase blood pressure and therefore persistent exposure to stress can worsen this factor. As for the summary of the stress frequency, the stress “sometimes” group had a 1.20 times increased risk of stress exposure though this difference was not yet statistically significant (χ²= 3.51, p=0.173). According to these results, the next studies show the correlation between stress and hypertension because pregnant women experience not only physical stress but also strong psychological pressure.
5.0 DISCUSSION OF RESULTS
This study’s findings show significant relationships between lifestyle characteristics and hypertensive disorders among third-trimester pregnant women at Banadir Hospital, Mogadishu. In particular, higher frequency of red meat intake was strongly linked to hypertensive disorders; 31.8% of women consuming red meat more than 2 times a week were in the sample, and 41.2% of them had hypertensive disorders compared to 22.4% in the control group (χ² = 7.64, p = 0.022). This concurs with Bergeron et al., (2019) who associate a high intake of red meat with high blood pressure resulting from the consumption of elevated saturated fat and cholesterol. Unlike processed meat, the current study did not demonstrate that the intake of processed meat has a direct relationship with the hypertension risk in this population (χ² = 2.43, p= 0.492) thus it can be inferred that red meat per se and not its processed or additives may pose a high risk for hypertension among the population under study. More attention should be paid to dietary changes, especially avoidance of red meat, as a protective factor against the development of hypertension in pregnancy in high-risk women.
Another risk factor linked with hypertensive disorders was smoking; 47.1% of hypertensive cases were current smokers compared with 29.4% in the control group (χ²=8.43, p=0.004). This is consistent with other literature including de Dimitriadis et al., (2022) that accredits smoking as a factor that causes hypertension through pathways like arterial wall rigidity and enhanced sympathetic function. These physiological stressors have been established as culprits raising blood pressure hence pointing out smoking as a modifiable risk factor. Notably, there was no correlation with alcohol consumption (p=0.733) or drug use (p=0.741); unlike other research findings, such as Puddey et al., (2019) that correlate heavy alcohol use with hypertension. Such findings may be due to reduced levels of alcohol and drug consumption among this sample since their drinking behaviour might be affected by cultural/ regional factors.
Finally, stress as a causal factor was identified for 30.5% of cases of hypertension and primarily coming out of workplace stress compared with 16.4% of the control group (χ²=6.68, p=0.035). This result complements other findings done in this field, like Ngene and Moodley (2019), who associate high blood pressure with chronic stress. One of the effects of pregnancy is stress and hormonal change during pregnancy enhances the stress effect resulting in hypertension. Other sources of stress, including family or home environment were also evaluated but their association with stress was not as strong as for work stress, indicating that work stress could have some specificity to blood pressure. All together, these findings underscore the value of such preventive measures as diet smoking cessation and stress reduction as essential tools in preventing hypertension and ensuring better maternal and fetal health.
6.0 CONCLUSION
In conclusion, the determinants of hypertensive disorders are lifestyle factors; red meat consumption, smoking, and stress from working places among third-trimester pregnant women at Banadir Hospital, Mogadishu. This was greatly observed with red meat consumption and smoking which yielded a higher prevalence of hypertension in those with higher consumption. Overall other factors such as alcohol consumption, processed meat intake, and salt usage did not reveal a relation with hypertensive disorders in this sample but workplace stress or job stress was proven to be directly related to raised hypertension risk. Such insights highlight the specific changes that are preventable and largely attribute hypertensive disorders of pregnancy to thus expecting healthcare interventions to be specific on dietary changes and physical activity.
7.0 RECOMMENDATIONS
The following specific recommendations are suggested for Banadir Hospital drawing from the analysis made. The healthcare providers should recommend that women-to-be change their diets, avoid red meat and processed foods, and eat more fruit and vegetables. As a proactive solution to the relationship between smoking and hypertension, antismoking assistance ought to form part of prenatal services. Other stress control measures include; prenatal exercises such as yoga and counseling for stress from work or other aspects of life. Screening tests when combined with the right patient management plans can help in identifying hypertensive risks and efficiently managing them. Last of all, community-based awareness creation health promotion crusades that aim at encouraging pregnant women to improve their health standards will also boost the already existing enhancement of health measures in the community. Summarized features of these interventions can help improve pregnancy and decrease hypertensive disorders.
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