Adverse neonatal outcomes in women with pre-eclampsia in Mulago Hospital, Kampala, Uganda: a cross-sectional study

Paul Kiondo,Gabriel S Bimenya,Pius Okong,Gakenia Wamuyu-Maina,Julius Wandabwa,Nazarius Mbona Tumwesigye

doi:10.11604/pamjs.supp.2014.17.1.3014

Abstract

INTRODUCTION: Pre-eclampsia, which is more prevalent in resource-limited settings, contributes significantly to maternal, fetal and neonatal morbidity and mortality. However, the factors associated with these adverse outcomes are poorly understood in low resource settings. In this paper we examine the risk factors for adverse neonatal outcomes among women with pre-eclampsia at Mulago Hospital in Kampala, Uganda. METHODS: A cross-sectional study was conducted at Mulago Hospital. Participants were 171 pregnant women diagnosed with pre-eclampsia in the Department of Obstetrics and Gynecology. Women were recruited from May 2008 to May 2009 and followed until they delivered. Bivariate and multivariate analyses were done to examine the correlates of adverse neonatal outcomes among this group of women. RESULTS: Predictors of adverse neonatal outcomes were: preterm delivery (OR 5.97, 95% CI: 2.97-12.7) and severe pre-eclampsia (OR 5.17, 95% CI: 2.36-11.3). CONCLUSION: Predictors of adverse neonatal outcomes among women with pre-eclampsia were preterm delivery and severe pre-eclampsia. Health workers need to identify women at risk, offer them counseling and, refer them if necessary to a hospital where they can be managed successfully. This may in turn reduce the neonatal morbidity and mortality associated with pre-eclampsia.

Highlights

Pre-eclampsia, which is more prevalent in resource-limited settings, contributes significantly to maternal, fetal and neonatal morbidity and mortality
In a study conducted in three hospitals in Uganda, severe pre-eclampsia/ eclampsia comprised 8% of cases of severe maternal morbidity [10] and in another study in Mulago Hospital, Uganda, severe pre-eclampsia/ eclampsia accounted for 12% of maternal deaths among women with severe maternal morbidity [11]
The perinatal outcomes in women with pre-eclampsia are poor, especially if pre-eclampsia is of early onset and is severe

Summary

Introduction

Pre-eclampsia, which is more prevalent in resource-limited settings, contributes significantly to maternal, fetal and neonatal morbidity and mortality. Pre-eclampsia is a multisystem disorder of pregnancy characterized by hypertension and proteinuria in the second half of pregnancy [1] It complicates 5-10% of all pregnancies [2, 3], but may be higher in resource-limited settings [4, 5]. Together with other hypertensive diseases of pregnancy, it is one of the leading cause of maternal, fetal and neonatal mortality and morbidity especially in resource limited-settings [4, 6, 7] where diagnosis and obstetric management are deficient [8, 9]. Haddad and colleagues [12], for example, studied maternal and perinatal outcomes among

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