Study Links Maternal Hypertension to Higher Rates of Low Birth Weight in Montserrat

Grethlyn West, Senior Health Information Officer at the Ministry of Health and Social Services, has presented new research showing that maternal hypertension is strongly linked to adverse birth outcomes on the island, particularly low birth weight.

Speaking at the Ministry’s annual research forum, West explained that the study was prompted by a 2024 local review which found Montserrat’s low birth weight rate stood at more than 7%, compared with just 3% in the United Kingdom. “We decided to investigate further to understand the possible cause,” she said.

The retrospective review analysed 678 deliveries at Glendon Hospital between 2010 and 2024, excluding births before 28 weeks. Researchers examined maternity and neonatal records to identify cases of maternal hypertension and diabetes and their impact on birth outcomes.

Key Findings

Adverse outcomes: 11.8% of all births were affected by preterm birth, low birth weight, or stillbirth. Preterm births (7.8%) were the most common, followed by low birth weight (7.2%) and stillbirth (1%).

Hypertension: 12.8% of mothers had hypertension, mostly pregnancy-induced. Babies born to hypertensive mothers were twice as likely to have low birth weight (16%).

Diabetes: 5.2% of mothers had diabetes, mainly gestational. However, no strong statistical link was found between diabetes and adverse outcomes in this dataset.

Comparisons: Montserrat’s low birth weight rate (7.2%) was considerably higher than the UK (2.9%) but in line with regional averages. Maternal hypertension prevalence was also relatively high compared with limited regional data.

West stressed the broader significance of the results: “Maternal health impacts generations. Addressing these conditions during pregnancy and even before an reduce risks to both mothers and their children.”

Recommendations

The study called for a multi-level response:

• Routine blood pressure checks and early intervention for hypertensive mothers, including low-dose aspirin and referrals for specialist care.
• Nutrition and lifestyle support for pregnant women, including diet, exercise, sleep, and stress management.
• Standardised glucose screening and tailored dietary plans for gestational diabetes, with post-partum follow-up.
• Continued cervical length screening and progesterone therapy for women at risk of preterm birth.
• Expansion of pre-conception counselling and childbirth education classes to strengthen maternal preparation.
• Use of the new electronic health information system to support predictive care planning.

West acknowledged the study’s limitations, including its small sample size and reliance on routine indicators, but said the findings provide an important baseline.

Audience questions highlighted the importance of early lifestyle interventions, even before pregnancy, and the reality of unplanned pregnancies in Montserrat. In response, West said pre-conception counselling remains a valuable tool. “We do acknowledge that we have planned and unplanned pregnancies, but we think it is important to to give people an idea what to take into consideration if they planning to get pregnant and how it can benefit them and their children,” she said.