Hormonal
contraceptives (HC) are thought to play a role in the pathogenesis of
cardiovascular diseases. The study evaluated the use of HC as a primary cause of preeclampsia (PE) among Ghanaians. This
study comprised 30 preeclamptic women
and 30 healthy normotensive pregnant women with over 20 weeks of
gestation at the Comboni Hospital, Ghana using a randomized case-control study. Blood pressure, weight,
height, socio-demographics, medical and previous obstetric history were taken
and recorded. Blood samples were collected for the estimation of homocysteine
and fasting lipids. Estimated foetal weight (EFW) and infant birthweight (BWT)
were obtained from maternal records. This study was carried out in 2019.80.0%
of women with PE used the hormonal contraceptive “depot medroxyprogesterone
acetate” (DMPA) prior to pregnancy. The use of DMPA was associated with about
thirty-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),
LDL-C (P=0.026), and homocysteine
levels (P<0.001) were significantly
elevated in the PE cases than the normal pregnant (NP) women, whilst EFW (P
References
[1]
Rivera, R., Yacobson, I. and Grimes, D. (1999) The Mechanism of Action of Hormonal Contraceptives and Intrauterine Contraceptive Devices. American Journal of Obstetrics & Gynecology, 181, 1263-1269.
https://doi.org/10.1016/S0002-9378(99)70120-1
[2]
Thadhani, R., Stampfer, M.J., Hunter, D.J., Manson, J.E., Solomon, C.G. and Curhan, G.C. (1999) High Body Mass Index and Hypercholesterolemia: Risk of Hypertensive Disorders of Pregnancy. Obstetrics & Gynecology, 94, 543-550.
https://doi.org/10.1097/00006250-199910000-00011
[3]
Arulkumaran, N. and Lightstone, L. (2013) Severe Pre-Eclampsia and Hypertensive Crises. Best Practice & Research: Clinical Obstetrics & Gynaecology, 27, 877-884.
https://doi.org/10.1016/j.bpobgyn.2013.07.003
[4]
Global Burden of Disease Study 2013 Collaborators (2015) Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 301 Acute and Chronic Diseases and Injuries in 188 Countries, 1990-2013: A Systematic Analysis for the Global Burden of Disease Study 2013. The Lancet (London, England), 386, 743-800.
[5]
Eiland, E., Nzerue, C. and Faulkner, M. (2012) Preeclampsia. Journal of Pregnancy, 2012, Article ID: 586578. https://doi.org/10.1155/2012/586578
[6]
Al-Jameil, N., Khan, F.A., Khan, M.F. and Tabassuma, H.A. (2014) Brief Overview of Preeclampsia. Journal of Clinical Medicine Research, 6, 1-7.
https://doi.org/10.4021/jocmr1682w
[7]
Obed, S. and Aniteye, P. (2006) Birth Weight and Ponderal Index in Pre-Eclampsia: A Comparative Study. Ghana Medical Journal, 40, 8-13.
[8]
Ahenkorah, L. (2009) Metabolic Syndrome, Oxidative Stress and Putative Risk Factors amongst Ghanaian Women Presenting with Pregnancy-Induced Hypertension. Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science & Technology, Kumasi.
[9]
Asare, G.A., Santa, S., Ngala, R., Asiedu, B., Afriyie, D. and Amoah, A.G.B. (2014) Effect of Hormonal Contraceptives on Lipid Profile and the Risk Indices for Cardiovascular Disease in a Ghanaian Community. International Journal of Women’s Health, 6, 597-603. https://doi.org/10.2147/IJWH.S59852
[10]
Kirkendall, W.M., Burton, A.C., Epstein, F.H. and Freis, E.D. (1967) Recommendations for Human Blood Pressure Determination by Sphygmomanometers. Circulation, 36, 980-988. https://doi.org/10.1161/01.CIR.36.6.980
[11]
Arias, F., Daftary, N.S. and Bhide, G.A. (2008) Practical Guide to High-Risk Pregnancy and Delivery. Elsevier, New Delhi.
[12]
Leveno, J.K. (2013) Williams Manual of Pregnancy Complications. 23rd Edition, The McGraw-Hill Companies, Inc., New York.
[13]
Meendering, J.R., Torgrimson, B.N., Miller, N.P., Kaplan, P.F. and Minson, C.T. (2008) Estrogen, Medroxyprogesterone Acetate, Endothelial Function, and Biomarkers of Cardiovascular Risk in Young Women. The American Journal of Physiology-Heart and Circulatory Physiology, 294, H1630-H1637.
https://doi.org/10.1152/ajpheart.01314.2007
[14]
Dudar, A.K. and Khadijih, A. (2010) Evaluating Use of Depo-Provera: A Closer Look at Association with Skeletal, Cardiovascular and Metabolic Systems. The University of Toledo Digital Repository, The University of Toledo, Toledo.
[15]
Batista, G.A., Souza, A.L., Marin, D.M., Sider, M., Melhado, V.C., Fernandes, A.M. and Alegre, S.M. (2016) Body Composition, Resting Energy Expenditure and Inflammatory Markers: Impact in Users of Depot Medroxyprogesterone Acetate after 12 Months Follow-Up. Archives of Endocrinology and Metabolism, 61, 70-75.
https://doi.org/10.1590/2359-3997000000202
[16]
Fallah, S., Nouroozi, V., Seifi, M., Samadikuchaksaraei, A. and Mokhtarned-Aghdashi, E. (2012) Influence of Oral Contraceptive Pills on Homocysteine and Nitric Oxide Levels: As Risk Factors for Cardiovascular Disease. Journal of Clinical Laboratory Analysis, 26, 120-123. https://doi.org/10.1002/jcla.21492
[17]
Adu-Bonsaffoh, K., Antwi, D.A., Obed, S.A. and Gyan, B. (2015) Nitric Oxide Dysregulation in the Pathogenesis of Preeclampsia among Ghanaian Women. Integrated Blood Pressure Control, 8, 1-6. https://doi.org/10.2147/IBPC.S68454
[18]
Braekke, K., Ueland, P.M., Harsem, N.K. and Staff, A.C. (2009) Asymmetric Dimethylarginine in the Maternal and Fetal Circulation in Preeclampsia. Pediatric Research, 66, 411-415. https://doi.org/10.1203/PDR.0b013e3181b33392
[19]
Lizarelli, P.M., Martins, W.P., Vieira, C.S., Soares, G.M., Franceschini, S.A. and Ferriani, R.A. (2009) Both a Combined Oral Contraceptive and Depot Medroxyprogesterone Acetate Impair Endothelial Function in Young Women. Contraception, 79, 35-40. https://doi.org/10.1016/j.contraception.2008.07.024
[20]
Ismiyati, A., Wiyasa, I.W. and Hidayati, D.Y. (2016) Protective Effect of Vitamins C and E on Depot-Medroxyprogesterone Acetate-Induced Ovarian Oxidative Stress in Vivo. Journal of Toxicology, 2016, Article ID: 3134105.
https://doi.org/10.1155/2016/3134105
[21]
Gupta, S., Agarwal, A. and Sharma, R.K. (2005) The Role of Placental Oxidative Stress and Lipid Peroxidation in Preeclampsia. Obstetrical & Gynecological Survey, 60, 807-816. https://doi.org/10.1097/01.ogx.0000193879.79268.59
[22]
Mahal, M., Yeasmin, F., Amin, S., Shahnaj, A., Rashid, M. and Hossain, M.S. (2009) Association of Serum Homocysteine and Serum Lipid with Eclampsia. JAFMC Bangladesh, 5, 7-10. https://doi.org/10.3329/jafmc.v5i1.2842
[23]
Fallah, S., Sanjary, P.M., et al. (2012) Adiponectin, Leptin and Lipid Profiles Evaluation in Oral Contraceptive Pill Consumers. Archives of Gynecology and Obstetrics, 285, 1747-1752. https://doi.org/10.1007/s00404-011-2192-3
[24]
Fallah, S. and Sanjary, M. (2015) The Effects of Hormonal Contraceptives on the Various Biomarkers Levels: A Review. IJBRITISH, 2, 131-171.
[25]
Mishell, D.R. (1996) Pharmacokinetics of Depot Medroxyprogesterone Acetate Contraception. The Journal of Reproductive Medicine, 41, 381-390.
[26]
Ashley, M., Nault, B.S., Jeffrey, F., Peipert, Z.Q. and Madden, T. (2013) Validity of Perceived Weight Gain in Women Using Long-Acting Reversible Contraception and Depot Medroxyprogesterone Acetate. American Journal of Obstetrics & Gynecology, 208, 48. https://doi.org/10.1016/j.ajog.2012.10.876
[27]
Vinod, T., Latti, R.G., et al. (2015) Correlation between Maternal Body Mass Index and Incidence of Pregnancy Induced Hypertension. Indian Journal of Basic and Applied Medical Research, 4, 86-90.
