Association of Hypertensive Disorders of Pregnancy (HDP) and tobacco use among women of reproductive age group in India: A secondary data analysis from NFHS-4

INTRODUCTION: Tobacco use in any form is known to exert several perinatal complications. Through this study, the authors aimed to study the association between tobacco use and Hypertensive Disorders of Pregnancy (HDP) among women (aged 15–49 years) in India. METHODOLOGY: We used data from the National Family Health Survey (NFHS-4, 2015–2016) to study the association between tobacco use and HDP among women of reproductive age (15–49 years) in India. Since the NFHS follows a complex multi-level sampling, sampling weights were used to study the univariate and multivariate associations between the independent and dependent variables. Adjusted odds ratios (AORs) are reported along with 95% Confidence Intervals. RESULTS: A sample of 1,07730 women was included in the analysis. HDP was more likely to be experienced by smokeless and smoking tobacco users (AOR 1.3, 95% CI (1.0-1.6) and AOR 2.7, 95% CI (2.0-3.7), respectively). Women with secondary (AOR 0.7, 95% CI (0.7-0.8)) and higher education (AOR 0.7, 95% CI (0.6-0.8)) were less likely to suffer from HDP as compared to those with no education. Women with daily (AOR 0.7, 95% CI (0.5-0.8)), weekly (AOR 0.8, 95% CI (0.6-0.9)) or occasional AOR 0.7, 95% CI (0.6-0.9)) consumption of fruits were less likely to experience HDP as compared to women with no fruit intake. CONCLUSION: Healthy diet and lifestyle factors can contribute to reduce the risk of HDP across women. The antenatal check-ups in India should also comprehensively focus on screening and counseling of women against tobacco use.