Determinants of adverse maternal and perinatal outcomes in severe preeclampsia and eclampsia in a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe

Solwayo Ngwenya,Desmond Mwembe,Brian Jones

doi:10.1186/s13104-019-4334-9

Solwayo Ngwenya, Desmond Mwembe + Show 1 more

Open Access

https://doi.org/10.1186/s13104-019-4334-9

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Abstract

ObjectiveSevere preeclampsia and eclampsia have dire consequences for both maternal and neonatal health. The objective of this study was to identify determinants of adverse maternal and perinatal outcomes in severe preeclampsia and eclampsia.ResultsBinary logistic regression showed the following were significantly associated with adverse maternal outcomes; mothers who had a baby born at 27–29+6 weeks of gestation were 8 times more likely to be associated with adverse maternal outcomes compared to mothers who gave birth at 37–39+6 weeks’ of gestation (OR 8.187, 95% CI 1.680–39.911, p = 0.02), holding other variables constant. Platelet count was also statistically significant for adverse maternal outcome. Mothers with platelet counts of 0–49 × 109/l were 46 times more likely to be associated with adverse maternal outcome compared to mothers with normal counts of more than 150 × 109/l (OR 46.429, 95% CI 17.778–121.253, p = 0.001). The following determinants were significantly associated with adverse perinatal outcomes. Mothers with platelet counts of 0–49 × 109/l were 4 times more likely to be associated with adverse perinatal outcomes compared to mothers with platelet counts of above 150 × 109/l (OR 3.690, 95% CI 1.752–7.775, p = 0.001).

Highlights

According to some German authors, the first reports referring to eclampsia date from 2200 BC, observed in papyri of ancient Egypt [1]
Mothers with platelet counts of 0–49 × 109/l were 46 times more likely to be associated with adverse maternal outcomes compared to mothers with normal counts of more than 150 × 109/l
Mothers who had platelet counts of 50–99 × 109/l counts were 19 times more likely to be associated with adverse maternal outcomes compared to those with platelet counts above 150 × 109/l and those with platelet counts of 100–149 × 109/l were 4 times more likely to be associated with adverse maternal outcomes compared to those with platelet counts above 150 × 109/l

Summary

Introduction

According to some German authors, the first reports referring to eclampsia date from 2200 BC, observed in papyri of ancient Egypt [1]. The incidence of preeclampsia remains underestimated due to underreporting [2]. Severe preeclampsia is defined once there is high blood pressure (i.e. BP > 160–170/100–110), heavy proteinuria of > 3–5 g/24 h, and/or the occurrence of symptoms, such as headache or visual disturbances [3]. Eclampsia occurs when a pregnant woman with features of severe preeclampsia has a grand mal seizure without prior history of epilepsy. Severe preeclampsia and eclampsia have dire consequences for both maternal and neonatal health, with 50,000–100,000 annual maternal deaths attributable to these conditions globally, as well as 500,000 fetal and neonatal deaths [4]. The three most common causes of maternal deaths are haemorrhage, hypertensive disorders and sepsis, accounting for more than half of maternal deaths worldwide as of 2010 [5]. Developing countries accounted for approximately 99% (302,000) of the global maternal deaths in 2015, with Sub-Saharan Africa alone accounting for roughly 66% (201,000) [6]

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