Incidence and Risk Factors of Pre-Eclampsia in the Paropakar Maternity and Women’s Hospital, Nepal: A Retrospective Study

Seema Das,Maria Lisa Odland,Jon Øyvind Odland,Gehanath Baral,Rashmita Bajracharya,Bina Jabegu,Rupesh Das

doi:10.3390/ijerph16193571

Abstract

This study aims to determine the incidence of pre-eclampsia and distribution of risk factors of pre-eclampsia at Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal. A retrospective study included 4820 pregnant women from 17 September to 18 December 2017. Data were obtained from the medical records of the hospital’s Statistics Department. Associations between the risk factors and pre-eclampsia were determined using logistic regression analysis and expressed as odds ratios. The incidence rate of pre-eclampsia in the study population was 1.8%. Higher incidence of pre-eclampsia was observed for women older than 35 years (Adjusted Odds Ratio, AOR)= 3.27; (Confidence Interval, CI 1.42–7.52) in comparison to mothers aged 20–24 years, primiparous women (AOR = 2.12; CI 1.25–3.60), women with gestational age less than 37 weeks (AOR = 3.68; CI 2.23–6.09), twins pregnancy (AOR = 8.49; CI 2.92–24.72), chronic hypertension (AOR = 13.64; CI 4.45–41.81), urinary tract infection (AOR = 6.89; CI 1.28–36.95) and gestational diabetes (AOR = 11.79; CI 3.20–43.41). Iron and calcium supplementation appear to be protective. Age of the mothers, primiparity, early gestational age, twin pregnancy, chronic hypertension, urinary tract infection and gestational diabetes were the significant risk factors for pre-eclampsia. Iron and calcium supplementation and young aged women were somewhat protective.

Highlights

Pre-eclampsia is an increase in systolic and diastolic blood pressure to ≥140 mm of Hg and ≥90 mm of Hg respectively in two or more consecutive occasions (≥4 h apart) after 20 weeks of gestation; the rise in blood pressure is combined with one or more of the following conditions: (1) proteinuria (a 24-h urine collection with a total protein excretion of ≥ 300mg or ≥ 1 + on urine dipstick); (2) evidence of other maternal organ dysfunction such as renal insufficiency, liver involvementInt
Incidence Rate and Distribution of Factors Associated with Pre-Eclampsia
A total of 4820 pregnant women of age 15–38 were included in the study, 1.8% (n = 85) had a diagnosis of pre-eclampsia with mean of maternal age and gestational age were 26.4 (5.2) and (16.7) respectively; and 98.2% (n = 4735) didn’t have a diagnosis of preeclampsia with mean of maternal age and gestational age were 24.4 (4.6) and (12.0)

Summary

Introduction

Pre-eclampsia is an increase in systolic and diastolic blood pressure to ≥140 mm of Hg and ≥90 mm of Hg respectively in two or more consecutive occasions (≥4 h apart) after 20 weeks of gestation; the rise in blood pressure is combined with one or more of the following conditions: (1) proteinuria (a 24-h urine collection with a total protein excretion of ≥ 300mg or ≥ 1 + on urine dipstick); (2) evidence of other maternal organ dysfunction such as renal insufficiency (creatinine < 90 umol/L), liver involvementInt.

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