Abstract
Introduction: To identify whether there is an association between maternal socioeconomic status as in living style, and preeclampsia in women from Pakistan, and if so, to what extent it increases the risk of developing preeclampsia. Methods: This is a case-control study, consisting of 74 normal pregnant and 76 already diagnosed preeclamptic Pakistani females, recruited from various hospitals in Karachi. Their socioeconomic status was assessed through the standard of living index (SLI) using the National Family Health Surveys (NFHS) criteria, which considers different living facilities as an indicator of socioeconomic status. Odds ratios of preeclampsia were calculated for low, middle and high socioeconomic status and other maternal anthropometric parameters. Results: Based on their groups, it appeared that the highest percentage of preeclamptic females (n= 65; 43.3%) and the lowest of control patients (n=14; 9.3%) lie in lower socioeconomic groups and the results were highly significantly different. Study observed that having lower socioeconomic status (P<0.001) significantly increase risk of having preeclampsia by 9% and middle socioeconomic status has no role in prevalence of preeclampsia shown by 0.0 odds ratio. In addition, odds ratio of age and PreBMI for the preeclamptic females were found as 1.37 (P<0.001) and 1.55 (P<0.001) respectively, which shows that each year increase in age, increases risk of preeclampsia by 1.37 times and 1.55 times with each increased in BMI. Conclusion: Living facilities are indications of socioeconomic status and are strong risk factors of preeclampsia
Highlights
To identify whether there is an association between maternal socioeconomic status as in living style, and preeclampsia in women from Pakistan, and if so, to what extent it increases the risk of developing preeclampsia
Preeclampsia can lead to fetal and maternal morbidity and mortality if it developed into eclampsia, which is serious fatal complication characterized by seizures [3]
High resistant spiral arteries remain persistently due to failure in this process, in addition to the obstruction in placental perfusion resulting in “relative hypoxemia”. This will eventually increase circulating soluble fms-like tyrosine kinase-1(sFlt1), while decreasing the placental growth factor (PGF) and vascular endothelial growth factor (VEGF) signalling into the mother’s blood leading to dysfunction of maternal endothelial cells [8]
Summary
To identify whether there is an association between maternal socioeconomic status as in living style, and preeclampsia in women from Pakistan, and if so, to what extent it increases the risk of developing preeclampsia. Preeclampsia is the most prevalent devastating disorder of pregnancy that causes about 5% of all pregnancy cases worldwide [1] It was characterized by having high blood pressure (Systolic: > 140mm of Hg and diastolic: > 90mm of Hg) with high proteinuria after 20 weeks of pregnancy. Preeclamptic maternal risk factors consist of youthful mothers, first pregnancy, previous history of preeclampsia, early-onset of disease, pre-existing medical conditions such as lupus erythematosus, antiphospholipid syndrome, previously diagnosed diabetes or hypertension [4]. High resistant spiral arteries remain persistently due to failure in this process, in addition to the obstruction in placental perfusion resulting in “relative hypoxemia” This will eventually increase circulating soluble fms-like tyrosine kinase-1(sFlt1), while decreasing the placental growth factor (PGF) and vascular endothelial growth factor (VEGF) signalling into the mother’s blood leading to dysfunction of maternal endothelial cells [8]. No proper prevention has been discovered, and treatment is aimed to cure of the symptoms only
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