Establishing Gestational Age-specific Blood Pressure Reference Ranges in Pregnancy and for Hypertensive Disorders among Tribal Women of Andhra Pradesh, India

Establishing Gestational Age-Specific Blood Pressure References-Protocol

Abstract

Background: The Tribal health program (ASARA) for tribal women in rural Andhra Pradesh, India, suggests that tribal women who show signs and symptoms of hypertensive disorders have lower blood pressure levels than the standard cut-offs. Objectives: In this study, we aim to define the reference ranges of systolic and diastolic blood pressure (before pregnancy, during pregnancy and within 42 days after delivery) correlated with clinically confirmed and self-reported symptoms of hypertensive disorders and their association with other maternal and lifestyle factors among women (15 – 49 years) living in selected tribal blocks of district Vishakhapatnam. Methodology: This is a prospective observational cohort study for 18 months duration in three tribal blocks of Vishakhapatnam, Andhra Pradesh. The study has two components: (1) line-listing of all non-pregnant tribal women through a door-to-door survey in selected geographical areas. (2) identification of three hundred tribal women who become pregnant in the first six months and following them up during their entire pregnancy and 42 days after childbirth. Anthropometric (weight), blood pressure measurements and urine albumin testing will be done before pregnancy through the door-to-door survey and during defined pregnancy for selected cohort of pregnant women. Findings: We will triangulate maternal, lifestyle, behavioural and sociodemographic data of the pregnant cohort with their blood pressure values and the reported signs and symptoms of hypertensive disorders. Ethics: Piramal Swasthya Management and Research Institute ethics committee approved this study. We also took administrative approval from The Integrated Tribal Development Agency and local health administration for field activities.

Keywords: Blood pressure, hypertensive disorder, tribal, pregnancy, reproductive age, prospective