Abstract
A retrospective case-control study was conducted to investigate the risk factors for pre-eclampsia – including the protective effect of placenta previa – at Medani Maternity Hospital, Sudan. Medical files of the patients during the period 2003–2010 were reviewed for age, parity, education level, prenatal care, placenta previa, and hemoglobin level. Women with pre-eclampsia were the cases, and women with normal pregnancy were the controls. There were 54,339 singleton deliveries and 1765 women with pre-eclampsia in the hospital, giving the incidence of pre-eclampsia of 3.2%. The risk factors for pre-eclampsia were; women with age >35 years (OR = 1.4, 95% CI: 1.1–1.8), primiparity (OR = 3.3, 95% CI: 2.7–4.0), para >5 (OR = 3.1, 95% CI: 2.4–4.0), and anemia (OR = 3.3, 95% CI: 2.8–3.9). The risk of pre-eclampsia was inversely increased with education level and prenatal care attendance. The prevalence of placenta previa was 0 (0%) and 55 (3.3%), P < 0.001 in pre-eclamptic and control women, respectively. Placenta previa was a significant protective factor of pre-eclampsia (OR = 0.3, 95% CI: 0.1–0.7). Although, the socio-demographic risk factors for pre-eclampsia observed among women at Medani hospital were similar to those found in other settings; placenta previa was associated with decreased incidence of pre-eclampsia.
Highlights
Pre-eclampsia, is one of the most common complications of pregnancy, it affects approximately 10% of births (Robilland et al, 2003)
1645 had complete data concerning age, parity, education level, prenatal care, placenta previa, and hemoglobin levels and they were included in the final analyses
The current study showed that anemic women were three times at higher risk for pre-eclampsia
Summary
Pre-eclampsia, is one of the most common complications of pregnancy, it affects approximately 10% of births (Robilland et al, 2003). It is a leading cause of maternal and perinatal mortality worldwide (Duley, 2009). The exact etiology of pre-eclampsia is not yet known, many risk factors have been demonstrated such as low education, primiparity, family history of hypertension, obesity, younger and advanced maternal age, and ethnicity (Conde-Agudelo and Belizán, 2000; Lee et al, 2000; Roberts et al, 2003; Sibai et al, 2005; Adeyinka et al, 2010). While some studies reported the protective effects, other studies did show any associations, slightly increase in the incidence and significantly elevated incidence pre-eclampsia in placenta previa (Little and Friedman, 1964; Brenner et al, 1978; Newton et al, 1984; Ananth et al, 1997; Hasegawa et al, 2011)
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