Prognostic factors of preeclampsia at Laquintinie Hospital in Douala, Cameroon: a hospital-based study

Christiane J. F. Nsahlai; Inna Rakya; Hadidza Z. Salissou; Kodoumé Motolouze; Bello M. I. Kutnjem; Henri L. C. Mol; Bertine M. Ndjeunga; Essiben Felix

doi:10.18203/2320-1770.ijrcog20261831

Authors

Christiane J. F. Nsahlai Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Cameroon
Inna Rakya Department de Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, The University of Garoua, Cameroon
Hadidza Z. Salissou Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Cameroon
Kodoumé Motolouze Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Cameroon
Bello M. I. Kutnjem Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Cameroon
Henri L. C. Mol Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Cameroon
Bertine M. Ndjeunga Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Cameroon
Essiben Felix Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Cameroon

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20261831

Keywords:

Preeclampsia, Maternal prognosis, Antenatal care, Risk factors, Cameroon, Maternal outcomes

Abstract

Background: Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity and mortality in Sub-Saharan Africa (SSA). Delayed diagnosis and limited resources compromise outcomes. Identifying predictors of favorable maternal outcomes may improve risk stratification and targeted interventions. This study evaluated predictors of favorable maternal prognosis among women with PE at Laquintinie Hospital, Douala, Cameroon.

Methods: We conducted an analytical cross-sectional study with retrospective data collection over five years (March 2020-2025). Medical records of women with PE were reviewed. Bivariate and multivariate logistic regression analyses were performed to identify factors independently associated with favorable maternal outcomes.

Results: Among 333 women with PE, maternal complications occurred in 32.4% of cases: eclampsia (33%) and maternal death (29%), with fetal distress the leading fetal complication (37.7%). Independent predictors of favorable maternal outcomes were ≥4 antenatal visits (adjusted OR=2.47; p=0.004), no previous PE (adjusted OR=1.99; p=0.027), gestational age ≥37 weeks (adjusted OR=1.72; p=0.001), and preserved consciousness at presentation (adjusted OR=4.91; p=0.019). Notably, neurological status emerged as the strongest predictor of prognosis, underscoring the importance of early recognition of severe disease before neurological deterioration occurs.

Conclusions: Favorable maternal outcomes in PE are driven not only by clinical severity but also by timely engagement with antenatal care (ANC) services. Identifying ANC use, gestational maturity, previous PE, and neurological status as key prognostic indicators provides targets for strengthening surveillance and referral systems in resource-limited settings. These findings support prioritizing early detection and close monitoring of high-risk women to reduce preventable maternal complications and deaths.

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References

Sentilhes L, Schmitz T, Arthuis C, Barjat T, Berveiller P, Camilleri C, et al. La pré-éclampsie : recommandations pour la pratique clinique du Collège national des gynécologues obstétriciens français. Gynécol Obstétr Fertil Sénol. 2024;52(1):3-44. DOI: https://doi.org/10.1016/j.gofs.2023.10.002

Melesse MF, Aynalem GL, Badi MB, Aynalem BY. Maternal outcomes of severe preeclampsia and eclampsia and associated factors among women admitted at referral hospitals of amhara regional state, institutional-based cross-sectional study, North-West Ethiopia. Front Glob Women’s Health. 2025;6:1555778. DOI: https://doi.org/10.3389/fgwh.2025.1555778

Ali M, Ahmed M, Memon M, Chandio F, Shaikh Q, Parveen A, et al. Preeclampsia: A comprehensive review. Clinica Chimica Acta. 2024;563:119922. DOI: https://doi.org/10.1016/j.cca.2024.119922

Institut Pasteur. Une nouvelle perspective thérapeutique de la prééclampsie. 2022. Available at: https://www.pasteur.fr/fr/espace-presse/documents-presse/nouvelle-perspective-therapeutique-preeclampsie. Accessed on 10 March 2026.

Prise en charge multidisciplinaire de la prééclampsie. Recommandations formalisées d’experts communes. Ann Françaises Anesthésie Réanimat. 2009;28(3):275-81. DOI: https://doi.org/10.1016/j.annfar.2009.02.015

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 Hypert. 2022;27:148-69. DOI: https://doi.org/10.1016/j.preghy.2021.09.008

Langtar MH, Allah-Amine AK, Narcisse D, Kiram MD, Tamoua ND, Bachar A, et al. Epidemiology and risk factors of persistent arterial hypertension after preeclampsia: a longitudinal study at the Chad-China Friendship Hospital. Pan Afr Med J. 2024;49:44. DOI: https://doi.org/10.11604/pamj.2024.49.44.43783

Diallo MH. Preeclampsie : Aspects Socio-Demographiques, Cliniques, Prise En Charge Et Pronostic A La Maternite De L’hopital Regional De Labe-Guinee. 2024;25(2):25-9.

Essome H, Koh VM, Ekono M, Boten M, Tocki TG, Foumane P. Pre-Eclampsia at Laquintinie Hospital (Douala): Survey of Prevalence and Morbidity from 2010 to 2015. Health Sci Dis. 2019;20(5):8-12.

Rawlins B, Plotkin M, Rakotovao JP, Getachew A, Vaz M, Ricca J, et al. Screening and management of pre-eclampsia and eclampsia in antenatal and labor and delivery services: findings from cross-sectional observation studies in six Sub-Saharan African countries. BMC Pregnancy Childbirth. 2018;18(1):346. DOI: https://doi.org/10.1186/s12884-018-1972-1

Sium AF, Getachew A, Gudu W. Pre-referral management of preeclampsia with severity features in a low-income country-characteristics and challenges in a Sub-Saharan setting: a mixed method study. AJOG Global Rep. 2024;4(3):100379. DOI: https://doi.org/10.1016/j.xagr.2024.100379

Kassa BG, Asnkew S, Ayele AD, Nigussie AA, Demilew BC, Mihirete GN. Preeclampsia and its determinants in Ethiopia: A systematic review and meta-analysis. Ahmed A, editor. PLoS ONE. 2023;18(11):e0287038. DOI: https://doi.org/10.1371/journal.pone.0287038

Birhanu MY, Temesgen H, Demeke G, Assemie MA, Alamneh AA, Desta M, et al. Incidence and Predictors of Pre-Eclampsia Among Pregnant Women Attending Antenatal Care at Debre Markos Referral Hospital, North West Ethiopia: Prospective Cohort Study. IJWH. 2020;12:1013-21. DOI: https://doi.org/10.2147/IJWH.S265643

Mukosha M, Vwalika B, Lubeya MK, Kumwenda A, Kaonga P, Jacobs C, et al. Determinants and neonatal outcomes of preeclampsia among women living with and without HIV at a tertiary hospital in Zambia: a review of medical records. Pan Afr Med J. 2022;43:110.

Khan ZL, Balie GM, Chauke L. Hypertensive Disorders of Pregnancy Deaths: A Four-Year Review at a Tertiary/Quaternary Academic Hospital. IJERPH. 2025;22(7):978. DOI: https://doi.org/10.3390/ijerph22070978

Fouedjio J, Mbongo J, Ngoune-Tegofack D, Ebong C, Dohbit J, Fouelifack Y, et al. Perinatal Outcome and Factors Associated with Hypertensive Disorders in Pregnancy in Yaoundé-Cameroon: A Retrospective Case-Control Study. Ann Gynecol Obstet. 2022;6(1):154-60. DOI: https://doi.org/10.36959/468/485

Boachie-Ansah P, Anto BP, Marfo AFA, Dassah ET, Mozu IE, Attakora J. Quality of antenatal care and outcomes of Hypertensive Disorders in Pregnancy among antenatal attendees: A comparison of urban and periurban health facilities in Ghana. Thet Wai K, editor. PLoS ONE. 2023;18(12):e0294327. DOI: https://doi.org/10.1371/journal.pone.0294327

Alemie T, Abebe A, Adal O, Azazh A, Endeshaw D. Clinical features and outcomes of patients with preeclampsia and eclampsia at Gondar University hospital, Amhara, Ethiopia 2021. Eur J Obstet Gynecol Reprod Biol X. 2023;20:100254. DOI: https://doi.org/10.1016/j.eurox.2023.100254

Abdiwali SA, Geta TG, Adesina OA, Fekadu GA. Effect of antenatal care attendance on maternal and birth outcomes in Somaliland: a cohort study. BMJ Open. 2026;16(3):e104470. DOI: https://doi.org/10.1136/bmjopen-2025-104470

Coban U, Takmaz T, Unyeli OD, Ozdemir S. Adverse Outcomes of Preeclampsia in Previous and Subsequent Pregnancies and the Risk of Recurrence. Sisli Etfal Hastan Tip Bul. 2021;55(3):426-31. DOI: https://doi.org/10.14744/SEMB.2020.56650

Bello NA, Zhou H, Cheetham TC, Miller E, Getahun D, Fassett MJ, et al. Prevalence of Hypertension Among Pregnant Women When Using the 2017 American College of Cardiology/American Heart Association Blood Pressure Guidelines and Association with Maternal and Fetal Outcomes. JAMA Netw Open. 2021;4(3):e213808. DOI: https://doi.org/10.1001/jamanetworkopen.2021.3808

Bernardes TP, Mol BW, Ravelli ACJ, Van Den Berg PP, Boezen HM, Groen H. Recurrence risk of preeclampsia in a linked population-based cohort: Effects of first pregnancy maximum diastolic blood pressure and gestational age. Pregnancy Hypert. 2019;15:32-6. DOI: https://doi.org/10.1016/j.preghy.2018.10.010

Ndwiga N, Ndwiga C, Osoti A, Pooja P, Odwe G, Warren C. The profile of early versus late onset preeclampsia-eclampsia at Kenyatta National Hospital: A retrospective cohort study. Pregnancy Hypert. 2018;13:S75. DOI: https://doi.org/10.1016/j.preghy.2018.08.223

Pembe AB, Dwarkanath P, Kikula A, Raj JM, Perumal N, Paulo HA, et al. Hypertensive disorders of pregnancy and perinatal outcomes: two prospective cohort studies of nulliparous women in India and Tanzania. BMJ Glob Health. 2025;10(7):e016339. DOI: https://doi.org/10.1136/bmjgh-2024-016339

Kefiyalew D, Aragaw A, Bula K, Etana G. Prevalence and maternal-fetal outcomes of early-onset versus late-onset of preeclampsia: a prospective cohort study at Wallaga university compressive specialized hospital. BMC Pregnancy Childbirth. 2026;26(1):245. DOI: https://doi.org/10.1186/s12884-026-08678-1

Duley L, Meher S, Abalos E. Management of pre-eclampsia. BMJ. 2006;332(7539):463-8. DOI: https://doi.org/10.1136/bmj.332.7539.463

Xu X, Wang Y, Xu H, Kang Y, Zhu Q. Association between proteinuria and maternal and neonatal outcomes in pre-eclampsia pregnancy: a retrospective observational study. J Int Med Res. 2020;48(4):0300060520908114. DOI: https://doi.org/10.1177/0300060520908114

Hayashida H, Nakamura K, Ukon K, Sato K, Mimura K, Kakuda M, et al. Atypical preeclampsia before 20 weeks of gestation with multicystic placenta, hyperreactio luteinalis, and elevated sFlt-1/PlGF ratio as manifestations of fetal triploidy: A case report. Case Rep Women’s Heal. 2022;33:e00379. DOI: https://doi.org/10.1016/j.crwh.2021.e00379

Wu J, Sheng X, Zhou S, Fang C, Song Y, Wang H, et al. Clinical significance of S100B protein in pregnant woman with early- onset severe preeclampsia. Ginekol Pol. 2024;95(9):711-7. DOI: https://doi.org/10.5603/GP.a2021.0126

von Dadelszen P, Vidler M, Tsigas E, Magee LA. Management of Preeclampsia in Low- and Middle-Income Countries: Lessons to Date, and Questions Arising, from the PRE-EMPT and Related Initiatives. Maternal-Fetal Med. 2021;3(2):917-26. DOI: https://doi.org/10.1097/FM9.0000000000000096