370. Risk factors of pulmonary edema among patients with pre-eclampsia : A case control study

Abstract

Introduction Pulmonary edema (PE), an uncommon event in preeclampsia, is associated with an increased risk of maternal and fetal morbidity and mortality. Patho-physiological changes associated with preeclampsia such as endothelial dysfunction and increased capillary permeability predispose them to PE. Due to the effect of anti-angiogenic mediators which is found to be increased in nulliparous women, the risk of development of PE is increased in these women compared to those with multiparity. We aimed to assesses the association of parity and other risk factors with development of pulmonary edema in preeclamptic women. Methods A matched case control study was conducted using data extracted from the hospital records matched for age during the time period January 2012 and December 2018 in a tertiary care and regional centre in South India. We used matched analysis using conditional logistic regression to assess the association of parity and other risk factors with pulmonary edema. Results PE developed in 2.67% of the preeclamptic women in this time period. More women were nulliparous among those who developed PE compared with the matched controls (76.7% vs. 50.0%, p = 0.032). Bivariate analysis adjusted for age showed nulliparous women to be at higher risk of development of PE (OR 5.0, 95%CI 1.06 23.41, p = 0.041). After adjusting for other variables (BMI, platelet counts, Systolic & diastolic blood pressure, presence of anaemia, serum albumin levels, and presence of help syndrome), analyses revealed matched OR of 5.44 (95% CI 1.36 −21.33) indicating that nulliparous women were at higher risk to develop PE compared with multiparous women). Conclusion Nulliparous preeclamptic women were found to be at increased risk of development of pulmonary edema. Being an uncommon complication, a prospective study, also taking into consideration of the stress on cardiac function, is needed to stratify the risk of PE.