Factors Associated with the Progression of Preeclampsia at Kinshasa University Clinics in Democratic Republic of Congo

Abstract

Background and aims: the progression of preeclampsia continues to increase in sub-Saharan Africa where care is inadequate. The objective of this study is to identify factors associated with the progression of preeclampsia at University Clinics of Kinshasa. Methods: This is a prospective and analytical study of 265 patients hospitalized at the Gynecology Service of the University Clinics of Kinshasa between January 1, 2006 and December 31, 2015. The clinical, biological, therapeutic and evolutionary characteristics were the parameters of 'interest. Cox regression in multivariate analyzes was generated to identify risk factors for progression to the p <0.05 threshold. Results: The cumulative frequency of preeclapse decreased from 6.0% in the first year to 64.2% at the end of the study with periods of stagnation in the rate. Predictors of the progression of preeclampsia in the study population for F values equal to 2.86, 2.10, 3.57, 3.23, 2.81 and 0.005 and an α risk equal at 0.009; 0.014; 0.006; 0.007; 0.005 and 0.006 0.0005, respectively, for age, level of education, occupation, SAP, DBP and figure 3, led us to reject the null hypothesis of equality of means between progression and the lack of progression. In multiple cox regression, the risk of progression of preeclampsia was 3 times respectively in parturients aged > 35 years (aRR: 2.57 95% CI: 1.89-4.75), in female employees (aRR: 2.83 95% CI: 1.97-4.46); this risk was 2 times respectively among academics, PAS and PAD elevated. Treatment under scheme 3, on the other hand, reduced the risk of progression 2 (aRR: 0.43 95% CI: 0.28-0.63). Conclusion: the progression of pre-eclampsia could be linked to certain socio-demographic and clinical factors. The role played by the treatment regimen of αmethyl Dopa + Nifedipine + Diazepam remains to be defined in this subgroup.