Maternal And Perinatal Outcomes Of Preeclampsia With Severity Features Managed In Jimma Medical Center, Jimma, Ethiopia, 2023gc

Abstract

Background: Preeclampsia refers to the new onset of hypertension and proteinuria after 20weeks of gestation in a previously normotensive woman. Pregnant women with preeclampsia with severe feature are at an increased risk of adverse maternal and perinatal outcomes. Objective: The objective of this study was to determine and compare perinatal and maternal outcome of women with Preeclampsia with severity features and normotensive women managed and gave birth at JUMC from July to October, 2023G.C Method: A Hospital based prospective cohort study was conducted among pregnant women with Preeclampsia with severity features and normotensive pregnant women who gave birth in Jimma University Medical Center. A pretested English version questionnaire was used to interview patients and reviewing their records which fulfill the inclusion criteria. The sample size was determined using STATCALC Epi info version 7.2.2.6 software and the final sample size required to get a statistically meaningful difference between the two groups was 224. (112 of exposed and 112 of unexposed). The data was collected by using structured questionnaire and checklist (using kobotoolbox) after proper orientation given for data collectors and was analyzed by using SPSS version 27. Chi-square test,Fischer exact test, nonparametric one sample test and independent T-test were used for comparisons, and logistic regression analysis was done. A 95% CI and P value < 0.05 were used to declare the level of statistical significance. Result: This prospective cohort study found out that compared to normotensive women; PE with severe feature is significantly associated with adverse perinatal outcomes such as LBW(39.3% , AOR = 8.5 [1.7, 41.7]), Prematurity (44.6%, AOR = 7.65[3.6 , 16.35]), ENND (17%, AOR =10.35[1.3,84.5] ), 5th minute low APGAR score (10.7%, AOR = 2.26 [0.63,8.2] ), admission to NICU(36.6%, AOR =2.7[1.2,5.9] ), perinatal death (21.4%, AOR = 5[1.3,18.5]) and overall adverse perinatal outcome(38.4%, AOR = 3.2[1.25,8.2]). This study also reveals higher level of adverse maternal outcomes was observed in the PE with severe feature compared to normotensive group. Among these maternal outcomes abruption placenta (10.7%), AKI(6.3%), HELLP syndrome (26.3%), PPH (4.5%) and overall adverse maternal outcome(37.5%) was found to be higher in PE with severe feature as compared to normotensive women, with statistically significant difference ( p<0.05). Conclusion: This study found out PE with severe feature is significantly associated with adverse perinatal and maternal outcomes. Hence, healthcare providers and the health facilities should strengthen prevention, early diagnosis and prompt management of PE with severe feature in order to better improve perinatal and maternal outcomes. Furthermore intervention towards HDP will signify to achieve global and national sustainable development goal (SDG) target to reducing neonatal mortality and maternal mortality.