Determinants of preeclampsia among pregnant and laboring mothers managed at Wolaita Sodo university comprehensive specialized hospital, South ethiopia: an unmatched case-control study

Abstract

BACKGROUND: Worldwide, preeclampsia continued to be one of a leading cause of maternal and perinatal morbidity and mortality. Indeed, developing countries like Ethiopia face significant public health challenges because of scarce data and limited applications of determinants of preeclampsia. Therefore, the aim of this research was to identify determinants of preeclampsia among pregnant and laboring mothers who came for antenatal care and labor and delivery services. METHODS: We conducted an unmatched case-control study among women diagnosed with preeclampsia and admitted to Wolaita Sodo University Comprehensive Specialized Hospital. Two hundred seventy women with case to control ratio of 1:2 were participated. We computed descriptive statistics like frequencies, percentages, mean, and standard deviation. An independent sample t-test was computed to compare the difference in means of cases and controls. Chi-squared test was used to compare categorical variables between cases and controls. To assess the association between dependent and independent variables, we carried out bivariable and multivariable logistic regressions. Variables whose p-value < 0.05 were considered as having strong association and strength of association was measured using an odds ratio (OR) with its corresponding 95% confidence level (CI). RESULTS: Pre-pregnancy overweight (OR = 6.7; 95%CI: 1.1-41.3 p = 0.0035), hypertension in the family member (OR = 3.1, 95%CI: 1.4-6.8, p = 004), multifetal gestation (OR = 5.4, 95% CI: 1.1-26, p = 003) and increased mid-gestation diastolic blood pressure of ≥ 80mmgh (OR = 7.6, 95%CI: 2.54-22.7, p = 0.002) were determinants of preeclampsia. Drinking coffee during pregnancy (OR = 0.27, 95%CI: 0.07, 0.94, p = 0.015) and iron and folic acid supplementation during pregnancy (OR = 0.48, 95%CI: 0.25-0.96, p = 0.041) were identified as protective factors. CONCLUSION: Odds of preeclampsia was higher in women with pre-pregnancy overweight, family history of hypertension, multifetal gestation, and high mid-gestation diastolic blood pressure, whereas supplementation of iron and folic acid lowers the risk of preeclampsia. Therefore, health care providers should emphasis on preconception care and thorough clinical evaluation during pregnancy, which may provide opportunity to detect women likely to develop preeclampsia. Nutritional intervention and conducting further research on protective factors like coffee intake is recommended to clarify the inconsistent findings.