Risk factors, phenotypic-pattern and feto-maternal outcomes of preeclampsia with severe features in a low-resource setting: a prospective study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20251551Keywords:
Risk factors, Phenotype, Severe preeclampsia, Fetomaternal outcomesAbstract
Background: Preeclampsia is exclusive to pregnancy and one of the leading causes of maternal and perinatal morbidity and mortality globally. This study aims to assess the prevalence, risk factors, phenotypic pattern and feto-maternal outcomes among women managed for preeclampsia with severe features at the Federal Medical Center Asaba.
Methods: Women managed for preeclampsia with severe features between 1st June 2022 and, 31st January 2023 were recruited and relevant data extracted and entered into a standardized proforma which was subsequently analyzed using the SPSS version 26. Categorical variables were expressed in frequencies and percentages while continuous variables were expressed as mean and standard deviation. The association test between the categorical variables was via the chi-square and Fisher exact test where necessary with a p<0.05 considered significant.
Results: The prevalence of preeclampsia with severe features was 19.3% with the late-onset type (63.7%) being the commonest. Maternal and perinatal outcomes were comparable in both phenotypical patterns except for NICU admission which was higher and significant for early onset. Nulliparity, chronic hypertension, and previous history of preeclampsia were the most commonly identified risk factors. Neonatal intensive care unit admission (43.8%), perinatal mortality (17.8%), admission into the intensive care unit (1.4%), and development of eclampsia (0.7%) were the most frequent fetomaternal outcomes.
Conclusions: This study revealed a high burden of preeclampsia with severe features and some of its complications. Interventions such as early antenatal care booking and prompt identification of at-risk women will reduce its burden.
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References
American College of Obstetricians and Gynaecologists (ACOG) Practice Bulletin No 222: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2020;135(6):e237. DOI: https://doi.org/10.1097/AOG.0000000000003891
Magee LA, Brown MA, Hall DR, Gupte S, Hennessy A, Karumanchi SA, et al. The 2021 International Society for the Study of Hypertension in Pregnancy Classification, Diagnosis and Management Recommendations for International Practice. Pregnancy Hypertens. 2022;27:148. DOI: https://doi.org/10.1016/j.preghy.2021.09.008
Ajah LO, Ozonu NC, Ezeonu PO, Lawani LO, Obuna JA, Onwe EO. The feto-maternal outcome of preeclampsia with severe features and eclampsia in Abakaliki, South-East Nigeria. J Clin of Diagn Res. 2016;10(9):QC18-21. DOI: https://doi.org/10.7860/JCDR/2016/21078.8499
Waugh JS, Smith MC. Hypertensive disorders. In: Edmonds DK, editor. Dewhurst’s Textbook of Obstetrics and Gynaecology 9th Ed. West Sussex UK: John Wiley and Sons, Ltd. 2018;73-84.
Musa J, Mohammed C, Ocheke A, Kahansim M, Pam V, Daru P. Incidence and risk factors for preeclampsia in Jos Nigeria. Afr Health Sci. 2018;18(3):584-95. DOI: https://doi.org/10.4314/ahs.v18i3.16
Elawad T, Scott G, Bone JN, Elwell H, Lopez CE, Filippi V, et al. Risk factors for preeclampsia in clinical practice guidelines: Comparison with the evidence. BJOG. 2024;131(1):46. DOI: https://doi.org/10.1111/1471-0528.17320
Njelita IA, Nwachukwu CC, Eyisi GI, Akabuike JCA, Ezenyeaku CA, Ifeadike CO. Determinants of preeclampsia in a tertiary hospital in South East Nigeria. Int J Med Sci Clin Invent. 2021;8(06):5490-7. DOI: https://doi.org/10.18535/ijmsci/v8i06.08
Hauge MG, Linde JJ, Kofoed KF, Ersboll AS, Johansen M, Sigvardsen PE, et al. Early-onset vs late-onset preeclampsia and risk of coronary atherosclerosis later in life: A clinical follow-up study. Am J Obstet Gynecol MFM. 2024;6:101371. DOI: https://doi.org/10.1016/j.ajogmf.2024.101371
Roberts JM, Rich-Edwards JW, McElrath TF, Garmire L, Myatt L. Subtypes of preeclampsia: Recognition and determining clinical usefulness. Hypertension. 2021;77:1430-41. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.120.14781
Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H. The International Federation of Gynecology and Obstetrics (FIGO) initiative on preeclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynecol Obstet. 2019;145(S1):1-33. DOI: https://doi.org/10.1002/ijgo.12802
Otalike FU, Otubu JAM, Bakut FS. Comparison of outcomes in early and late-onset preeclampsia in two district hospitals in Abuja. Trop J Obstet Gynaecol. 2022;39(1):12-7.
Gomathy E, Lahari A, Kondareddy R. Early onset and late onset preeclampsia-maternal and perinatal outcomes in a rural tertiary health centre. Int J Reprod Contracept Obstet Gynecol. 2018;7(6):2266-9. DOI: https://doi.org/10.18203/2320-1770.ijrcog20182333
Awoyesuku PA, John DH, Lebara LB. Maternal and perinatal outcome in severe preeclampsia and eclampsia at the Rivers State University Teaching Hospital, Nigeria. Int J Reprod Contracept Obstet Gynecol. 2020;9:4382-8. DOI: https://doi.org/10.18203/2320-1770.ijrcog20204784
Ilikannu SO, Ebeigbe PN, Ochei AU. Pritchard’s Regimen: The effect of 12-hour versus 24-hour magnesium sulphate maintenance regimen on the occurrence of seizures and maternal outcome in women with severe features of preeclampsia: A triple-blind randomized controlled trial. Nigeria Med J. 2024;63(3):320-31.
Fagbemi AJ, Jombo SE, Ilikannu SO, Ossai CA, Eyeregba U, Iyiola AA, et al. A five-year review of maternal mortality in Federal Medical Centre Asaba Delta State. Int J Clin Obstetr Gynaecol. 2024;8(3):80-5. DOI: https://doi.org/10.33545/gynae.2024.v8.i3b.1453
Eugene IM, Isaac AJ. Seasonal variations in the incidence of preeclampsia-eclampsia in Bayelsa State in the Niger Delta region of Nigeria. Indian J Obstet Gynecol Res. 2020;7(2):157-62. DOI: https://doi.org/10.18231/j.ijogr.2020.033
Ayogu ME, Akaba GO, Offiong RA, Adewole ND, Ekele BA. Risk factors for hypertensive disorders of pregnancy in Abuja, Nigeria: A prospective case-control study. Trop J Obstet Gynaecol. 2020;37:46-52. DOI: https://doi.org/10.4103/TJOG.TJOG_88_19
Anorlu RI, Iwuala NC, Odum CU. Risk factors for preeclampsia in Lagos, Nigeria. Aust N Zeal J Obstet Gynaecol. 2005;45(4):278-82. DOI: https://doi.org/10.1111/j.1479-828X.2005.00411.x
Onwusulu DN, Enebe JT, Nwafor AV, Jombo SE, Ilikannu SO, Ogbomade CC, et al. Prevalence and pregnancy outcomes of preeclampsia/eclampsia phenotypes: A multicenter prospective cross-sectional study. Int J Med Health Dev. 2025;30(2):127-32. DOI: https://doi.org/10.4103/ijmh.ijmh_65_24
Teka H, Yemane A, Abraha HE, Berhe E, Tadesse H, Gebru F, et al. Clinical presentation, maternal-fetal, and neonatal outcomes of early-onset versus late-onset preeclampsia-eclampsia syndrome in a teaching hospital in a low-resource setting: A retrospective cohort study. PLoS One. 2023;18(2):e0281952. DOI: https://doi.org/10.1371/journal.pone.0281952
Shrestha J, Subedi A, Gurung SD, Gauchan E, Shrestha S, Pandey C. Pregnancy outcome in early versus late-onset preeclampsia. Nep J Obstet Gynecol. 2021;16(33):53-9. DOI: https://doi.org/10.3126/njog.v16i2.42101
Ugwu EOV, Dim CC, Okonkwo CD, Nwankwo TO. Maternal and perinatal outcome of severe preeclampsia in Enugu, Nigeria after the introduction of magnesium sulphate. Niger J Clin Pract. 2011;14(4):418-21. DOI: https://doi.org/10.4103/1119-3077.91747
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