The Use of Hormonal Contraceptives and Preeclampsia among Ghanaian Pregnant Women

Abstract

Hormonal \ncontraceptives (HC) are thought to play a role in the pathogenesis of \ncardiovascular diseases. The study evaluated the use of HC as a primary cause of preeclampsia (PE) among Ghanaians. This \nstudy comprised 30 preeclamptic women \nand 30 healthy normotensive pregnant women with over 20 weeks of \ngestation at the Comboni Hospital, Ghana using a randomized case-control study. Blood pressure, weight, \nheight, socio-demographics, medical and previous obstetric history were taken \nand recorded. Blood samples were collected for the estimation of homocysteine \nand fasting lipids. Estimated foetal weight (EFW) and infant birthweight (BWT) \nwere obtained from maternal records. This study was carried out in 2019. 80.0% \nof women with PE used the hormonal contraceptive “depot medroxyprogesterone \nacetate” (DMPA) prior to pregnancy. The use of DMPA was associated with about \nthirty-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), \nLDL-C (P = 0.026), and homocysteine \nlevels (P 0.001) were significantly \nelevated in the PE cases than the normal pregnant (NP) women, whilst EFW (P 0.001), BWT (P 0.001) \nand HDL-C levels (P = 0.001) were significantly \nreduced in the PE cases when compared to NP women. 50% and 47% of PE cases had \nintrauterine growth restriction and low birthweight infants, respectively. In \nconclusion, DMPA use predisposes women to a high risk of developing PE. DMPA \ncould partly contribute to endothelial dysfunction, hyperhomocysteinaemia, \ndyslipidaemia and excessive weight gain, all of which characterize PE.