Undiagnosed hypertension among pregnant women in Peru: prevalence, inequities, and geographic variability. Analysis of the demographic and family health survey.

Objective

To estimate the prevalence of undiagnosed hypertension among pregnant women in Peru, assess socioeconomic inequities, and characterize departmental geographic variability during 2014-2024.

Methods

We conducted an analytical cross-sectional study using the Demographic and Family Health Survey (ENDES) 2014-2024. The sample included 5243 pregnant women aged 15-49 years with valid blood pressure measurements and no prior hypertension diagnosis. Undiagnosed hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg among women without self-reported diagnosis. Weighted prevalences and 95% confidence intervals (95% CI) were estimated. Socioeconomic inequities were assessed using the Slope Index of Inequality (SII), Relative Index of Inequality (RII), and Erreygers concentration index. Spatial autocorrelation was assessed using Moran's I.

Results

The prevalence of undiagnosed hypertension was 5.6% (95% CI: 4.4-6.7). Prevalence was higher in urban than rural areas (6.1% vs 4.2%) and in the richest versus poorest quintile (6.4% vs 3.8%), although these contrasts were imprecise. The SII was 3.36 percentage points (95% CI: -0.72 to 7.44), the RII was 1.83 (95% CI: 0.92-3.64), and the Erreygers index was 0.021 (95% CI: 0.007-0.035; p = 0.003), indicating a small pro-rich concentration. Moran's I was positive and statistically significant after correction to 25 ENDES spatial units (I = 0.294; p = 0.013).

Conclusions

Undiagnosed hypertension affected approximately one in eighteen pregnant women in Peru. Findings suggest modest pro-rich concentration and significant departmental spatial autocorrelation.