Overweight and Obesity among Women with Pregnancy-induced Hypertension in Sierra Leone: Age Patterns and Comparison with the National Population of Women of Reproductive Age
Neneh Conteh Vandy
District Health Management Tean, Kenema District, Sierra Leone.
Abdulai Sillah *
Department of Agribusiness Management, Njala University, Mokonde, Sierra Leone.
Marion Malia Jigba
Department of Vocational and Technical Education, EBKUST University, Magbruka, Sierra Leone.
Finda Miriam Musu Barrie
Department of Home Science, Milton Margai Technical University, Sierra Leone.
Fatmata Kadiatu Kamara
Department of Home Sciences, Methodis High School, Bo District, Sierra Leone.
*Author to whom correspondence should be addressed.
Abstract
Background: Overweight and obesity may contribute to hypertensive disorders of pregnancy, but age-specific patterns among affected women outside Sierra Leone’s capital remain insufficiently described. This study examined body mass index (BMI) among women with pregnancy-induced hypertension (PIH) and compared overweight or obesity prevalence with national estimates.
Methods: A retrospective review included 553 women with recorded PIH at Bo Government Hospital from January 2018 to June 2023. BMI categories were examined by age using permutation χ² and Cochran–Armitage tests. Comparisons used age-specific estimates for 7,514 non-pregnant women in the 2019 Sierra Leone Demographic and Health Survey. Prevalence ratios, indirect standardisation and a tipping-point bias analysis were used to examine differences and possible misclassification arising from gestational weight gain.
Results: Among women with PIH, 37.1% were overweight, 20.4% were obese and 1.8% were underweight. The combined prevalence of overweight or obesity was 57.5% (95% confidence interval [CI] 53.3–61.6), without a significant age trend (p = 0.49). Prevalence was 60.8% among those aged 16–20 years. Age-specific prevalence ratios relative to the national reference were 3.50, 1.77 and 1.62 from youngest to oldest. The age-standardised prevalence ratio was 2.43 (95% CI 2.17–2.71). The modelled excess disappeared when 58.8% of women classified as overweight or obese were assumed to have been misclassified.
Conclusions: Overweight and obesity were more prevalent among women with PIH than among non-pregnant women nationally, particularly at younger ages. The comparison should be interpreted cautiously because BMI was recorded during pregnancy.
Keywords: Pregnancy-induced hypertension, pre-eclampsia, body mass index, overweight, obesity, nutrition transition, maternal nutrition, Sierra Leone