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Eticha TG, Berhe S, Deressa A, Firdisa D, Tura AK. Determinants of preeclampsia among women who gave birth at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia: a case-control study. Sci Rep 2024; 14:18744. [PMID: 39138269 PMCID: PMC11322304 DOI: 10.1038/s41598-024-69622-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 08/07/2024] [Indexed: 08/15/2024] Open
Abstract
Pre-eclampsia and eclampsia are the second leading causes of maternal mortality and morbidity. It also results in high perinatal mortality and morbidity. Since eclampsia is preceded by preeclampsia and shows the progression of the disease, they share the same pathogenesis and determining factors. The purpose of this study was to determine determinants of preeclampsia, since it is essential for its prevention and/or its associated consequences. An unmatched case-control study was conducted from September 1-30, 2023 among women who gave birth from June 1, 2020, to August 31, 2023, at Hiwot Fana Comprehensive Specialized University Hospital. Women who had preeclampsia were considered cases, while those without were controls. The sample size was calculated using EPI Info version 7 for a case-control study using the following assumptions: 95% confidence interval, power of 80%, case-to-control ratio of 1:2, and 5% non-response rate were 305. Data was collected using Google Form, and analyzed using SPSS version 26. Variables that had a p-value of < 0.05 on multivariable logistic regression were considered statistically significant, and their association was explained using an odds ratio at a 95% confidence interval. A total of 300 women (100 cases and 200 controls) with a mean age of 24.4 years were included in the study. Rural residence (AOR 2.04, 95% CI 1.10-3.76), age less than 20 years (AOR 3.04, 95% CI 1.58-5.85), history of hypertensive disorders of pregnancy (AOR 5.52, 95% CI 1.76-17.33), and no antenatal care (AOR 2.38, 95% CI 1.19-4.75) were found to be the determinants of preeclampsia. We found that living in a rural areas, previous history of preeclampsia, no antenatal care, and < 20 years of age were significantly associated with preeclampsia. In addition to previous preeclampsia, younger and rural resident pregnant women should be given attention in preeclampsia screening and prevention.
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Affiliation(s)
- Tadesse Gure Eticha
- Department of Obstetrics and Gynecology, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Solomon Berhe
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemayehu Deressa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Firdisa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of International Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Kassa BG, Asnkew S, Ayele AD, Nigussie AA, Demilew BC, Mihirete GN. Preeclampsia and its determinants in Ethiopia: A systematic review and meta-analysis. PLoS One 2023; 18:e0287038. [PMID: 37963147 PMCID: PMC10645334 DOI: 10.1371/journal.pone.0287038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/30/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Preeclampsia is a serious condition that is linked to poor perinatal outcomes. In Ethiopia, the overall prevalence of preeclampsia and its associated factors is uncertain. Therefore, the purpose of this review was to find the prevalence of pre-eclampsia and its determinants in Ethiopia. METHODS To find primary studies, PubMed, Google Scholar, HINAR, Scopus, the Web of Sciences, and grey literature searches were used between January 1, 2013, and January 1, 2023, in Ethiopia. A Microsoft Excel sheet was used to extract data. The pooled prevalence of pre-eclampsia was predicted using a random-effect model. RESULTS Twenty-nine studies were included. The pooled prevalence of pre-eclampsia was 11.51% (95% CI: 8.41, 14.61). Age > 35 years old (AOR = 2.34, 95%CI, 1.74-2.94; p-value = 0.64), housewife (AOR = 2.76, 95%CI, 1.2-4.32; p-value = 0.37), previous history of pre-eclampsia (AOR = 4.02, 95%CI, 2.91-5.55; p-value = 0.09), family history of hypertension (OR = 1.84, 95%CI, 1.39-2.3; p-value = 0.4), history of chronic hypertension (AOR = 2.44, 95%CI, 1.8-3.08; p-value = 0.67), history of multiple pregnancies (AOR = 1.45, 95%CI, 1.09-1.8; p-value = 0.38), and alcohol intake during pregnancy (AOR = 1.53, 95%CI, 1.03-2.04; p-value = 0.03) were the determinants of pre-eclampsia. CONCLUSIONS When compared to previous studies, the overall pooled prevalence of pre-eclampsia was high. Pre-eclampsia is associated with maternal age >35 years, being a housewife, having a history of preeclampsia, having a history of chronic hypertension, having a family history of hypertension, having diabetes mellitus, drinking alcohol during pregnancy, and having multiple pregnancies.
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Affiliation(s)
- Bekalu Getnet Kassa
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sintayehu Asnkew
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alemu Degu Ayele
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Azezu Asres Nigussie
- Department of Midwifery, College Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Basaznew Chekol Demilew
- Department of Anesthesia, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gedefaye Nibret Mihirete
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Meng Y, Liu J, Ji C, Zhang R, Hua Z, Chen J, Wang H, Wan S, Gao S, Yang X. Human leukocyte antigen-G 14 bp insertion/deletion polymorphism contributes to preeclampsia risk in Asian population: A systematic review and meta‑analysis. J Reprod Immunol 2023; 159:104135. [PMID: 37633154 DOI: 10.1016/j.jri.2023.104135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 08/28/2023]
Abstract
Preeclampsia remains enigmatic and responsible for vast maternal and fetal morbidity and mortality worldwide. Our objective was to assess the strength of the effect of the 14 bp deletion/insertion polymorphism in exon 8 of the 3'UTR region of the human leukocyte antigen-G (HLA-G) gene on preeclampsia risk across different populations. A systematic review by a meta-analysis was performed to summarize the scattered epidemiologic evidence, which remains inconclusive and controversial. A systematic literature search according to the PRISMA guidelines was conducted to screen relevant publications. Odds ratio and corresponding 95% confidence interval were estimated to measure the magnitude of the association between this polymorphism and preeclampsia onset. Thirty studies comprising 9402 subjects were eligible. Pooled estimates suggested that both fetal and paternal insertion variants were significantly associated with increased odds of this disease. Nevertheless, the presence of the 14 bp insertion sequence in mothers does not seem to increase the risk of preeclampsia. Moreover, the results of subgroup analysis suggested that the fetal, maternal, and paternal polymorphism has a significant deleterious impact on the preeclampsia risk in the Asian population. In addition, the significant association between the paternal polymorphism and preeclampsia in primigravida was observed in the pooled estimation with a small sample size. By summarizing the amount of significant evidence, our study nominated this polymorphism as a potential biomarker for early risk stratification for Asians. Further large-scale validation is needed to establish fully solid and conclusive evidence for the impact of the insertion polymorphism on preeclampsia risk.
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Affiliation(s)
- Ye Meng
- Center for Systems Biology, Department of Bioinformatics, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, Jiangsu Province 215123, China; Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province 215123, China
| | - Jinghua Liu
- Center for Systems Biology, Department of Bioinformatics, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, Jiangsu Province 215123, China; Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province 215123, China
| | - Chenxi Ji
- Center for Systems Biology, Department of Bioinformatics, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, Jiangsu Province 215123, China; Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province 215123, China
| | - Ruting Zhang
- Center for Systems Biology, Department of Bioinformatics, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, Jiangsu Province 215123, China; Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province 215123, China
| | - Zixiao Hua
- Center for Systems Biology, Department of Bioinformatics, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, Jiangsu Province 215123, China; Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province 215123, China
| | - Jing Chen
- Center for Systems Biology, Department of Bioinformatics, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, Jiangsu Province 215123, China; Suzhou Medical College of Soochow University, Suzhou, Jiangsu Province 215123, China
| | - Haoqi Wang
- Jiangsu Suzhou Experimental Middle School, Science and Technology City Campus, Suzhou, Jiangsu Province 215163, China
| | - Shan Wan
- Department of Pathology, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, Jiangsu Province 215123, China.
| | - Shangshang Gao
- Department of Biochemistry and Molecular Biology, Soochow University, Suzhou, Jiangsu Province 215123, China.
| | - Xiaoqin Yang
- Center for Systems Biology, Department of Bioinformatics, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, Jiangsu Province 215123, China.
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Tesfa E, Munshea A, Nibret E, Gizaw ST. Determinants of pre-eclampsia among pregnant women attending antenatal care and delivery services at Bahir Dar public hospitals, northwest Ethiopia: A case-control study. Health Sci Rep 2023; 6:e1440. [PMID: 37519426 PMCID: PMC10372301 DOI: 10.1002/hsr2.1440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/09/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Background and Aims Pre-eclampsia (PE) is a pregnancy-related syndrome that occurs after 20 weeks of pregnancy. The current study was designed to evaluate the determinants of PE in pregnant women following antenatal and delivery services. Methods An institution-based case-control study was performed in governmental hospitals of Bahir Dar city. The data were collected using an interview-administered questionnaire and analyzed by SPSS version 20 software. Bivariate and multivariable logistic regression models were utilized for the analysis of variables. A p < 0.05 was used to declare the level of significance. Results In this study, the mean ages (in years) of cases and controls were 28.20 ± 5.66 and 27.52 ± 4.70, respectively. Factors such as: being primiparous (adjusted odds ratio [AOR]: 3.19 at 95% confidence interval [CI]: 1.71, 5.97), family history of hypertension (HTN) (AOR: 4.14 at 95% CI: 1.71, 10.05), previous history of PE (AOR: 7.97 at 95% CI: 2.42, 26.63), number of antenatal care (ANC) visits (AOR: 5.43 at 95% CI: 2.86, 10.33), not taking iron and folic acid supplement (AOR: 4.46 at 95% CI: 1.59, 12.48), body mass index ≥25 kg/m2 (AOR: 3.47 at 95% CI: 1.78, 6.77), not consuming vegetables (AOR: 1.99 at 95% CI: 1.07, 3.69) and not consuming egg, milk and milk products (AOR: 3.00 at 95% CI: 1.47, 6.11) were the determinants of PE. Conclusion In this study, different determinants of PE were identified. Hence, special attention should be given for primiparous women, women having previous history of PE and family history of HTN. Moreover, nutritional counseling should be given for pregnant women during ANC visits. Besides, higher officials should design an appropriate strategy to increase the number of mothers to complete their ANC visits and to take iron and folic acid supplements. Furthermore, to verify the determinants of PE, community-based cohort studies are warranted.
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Affiliation(s)
- Endalamaw Tesfa
- Department of Medical Biochemistry, College of Medicine and Health SciencesBahir Dar UniversityBahir DarEthiopia
- Division of Health Biotechnology, Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
| | - Abaineh Munshea
- Division of Health Biotechnology, Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
- Department of BiologyBahir Dar UniversityBahir DarEthiopia
| | - Endalkachew Nibret
- Division of Health Biotechnology, Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
- Department of BiologyBahir Dar UniversityBahir DarEthiopia
| | - Solomon Tebeje Gizaw
- Department of Medical Biochemistry, College of Health ScienceAddis Ababa UniversityAddis AbabaEthiopia
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Dasari A, Jacob PM, Jeyapaul S, Mathew AJ, Abraham VJ, Cherian AG. Description and outcomes of patients with eclampsia and severe pre-eclampsia in a rural hospital in North-Eastern Bihar: A retrospective study. J Family Med Prim Care 2022; 11:6096-6100. [PMID: 36618200 PMCID: PMC9810891 DOI: 10.4103/jfmpc.jfmpc_286_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/23/2022] [Accepted: 05/10/2022] [Indexed: 11/11/2022] Open
Abstract
Background Hypertension is one of the most common medical disorders complicating pregnancy. In India, high blood pressure contributes to 7.1% of maternal deaths. This study was carried out to describe the characteristics and pregnancy outcomes of patients presenting with eclampsia or pre-eclampsia to a secondary care hospital in rural India. Methods Patients diagnosed with pre-eclampsia or eclampsia between January 2018 and April 2021 were identified and included in the study. Medical records were searched and general patient characteristics, obstetrical history, information about the antenatal period, mode of delivery and outcomes were documented and analysed. Results Among the 3651 women who delivered in this hospital during this time period, 2.3% (n = 83) presented with eclampsia and 1.9% (n = 71) with pre-eclampsia. More than 50% of the women delivered by lower segment caesarean section among both the eclamptics and pre-eclamptics. The stillbirth rate among those with either pre-eclampsia or eclampsia was 1 per 1000. The number of low birth weight babies born to those presenting with eclampsia (66.7%) was significantly more than those presenting with pre-eclampsia (48.6%). Eclampsia/pre-eclampsia accounted for 21% of all maternal deaths with a case fatality rate of 2.6%. Conclusions This study identified that in this setting the patients presenting with eclampsia were much higher than those presenting with pre-eclampsia which is in stark contrast to the status even in developing countries. This could be an important finding indicating poorer health-seeking behaviour among the population and will need more studies on various interventions to change this status.
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Affiliation(s)
- Amos Dasari
- Madhipura Christian Hospital, Madhipura, Bihar, India
| | | | - Shalini Jeyapaul
- Department of Community Health, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | | | - Vinod J. Abraham
- Department of Community Health, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Anne G. Cherian
- Department of Community Health, Christian Medical College and Hospital, Vellore, Tamil Nadu, India,Address for correspondence: Dr. Anne G. Cherian, Department of Community Health, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. E-mail:
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Zeng L, Liao C. Multivariate logistic regression analysis of preeclampsia in patients with pregnancy induced hypertension and the risk predictive value of monitoring platelet, coagulation function and thyroid hormone in pregnant women. Am J Transl Res 2022; 14:6805-6813. [PMID: 36247275 PMCID: PMC9556439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/19/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Multivariate logistic regression analysis of preeclampsia in patients with pregnancy induced hypertension and the risk predictive value of monitoring platelet, coagulation function and thyroid hormone in pregnant women. METHODS The data of 120 pregnant women who delivered their babies at Xinyu Maternal and Child Health Hospital from January 2019 to January 2022 were analyzed retrospectively. Among the subjects studied, 60 were patients with preeclampsia as a study group and 60 healthy pregnant women were assigned to a control group. The clinical data of pregnant women were recorded, including age, weight gain during pregnancy, nationality, education level, times of antenatal examinations, times of pregnancy and parturition, discovery of gestational weeks, multiple pregnancies, amniotic fluid volume, neonatal weight, history of in vitro fertilization combined with embryo transfer, history of diabetes, kidney disorders or preeclampsia, family background of high blood pressure, anemia and so on. The clinical test data, such as platelet count and volume, coagulation function and thyroid hormone, were collected in two groups of pregnant women. Multivariate logistic regression analysis was performed on preeclampsia. The predictive value of platelet, coagulation function and thyroid hormone on preeclampsia was explored. RESULTS We compared the general hematological parameters. Univariate Logistic analysis found that age, history of diabetes, nephropathy or preeclampsia, family background of elevated blood pressure, weight gain during pregnancy, frequency of pregnancy and multiple pregnancies were all risk factors for preeclampsia. Multivariate Logistic regression analysis screened out that age, history of diabetes, kidney disorders or preeclampsia, family background of hypertension were independent risk factors for preeclampsia. The white blood cell count and platelet count of the study group were lower than those of the control group. Moreover, observed patients displayed a larger average platelet volume (P<0.05). Significant differences were found in glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, lactate dehydrogenase, albumin, serum creatinine and uric acid, as well as in thrombin time and activated partial thromboplastin time between the two groups (P<0.05). In terms of thyroid function, obvious differences were found in serum thyrotropin and free thyroxine between the two groups (P<0.05). CONCLUSION Age, history of diabetes, kidney disorders or preeclampsia, family background of highly blood pressure are independent risk factors for preeclampsia. Platelet, coagulation function and thyroid hormone levels can have a certain risk predictive value.
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Affiliation(s)
- Li Zeng
- Obstetrics Department, Xinyu Maternal and Child Health Care HospitalXinyu 338000, Jiangxi, China
| | - Chunfang Liao
- Gynaecology and Obstetrics, Affiliated Hospital of Jinggangshan UniversityJi’an City 343000, Jiangxi Province, China
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Flavonoids exert potential in the management of hypertensive disorders in pregnancy. Pregnancy Hypertens 2022; 29:72-85. [DOI: 10.1016/j.preghy.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022]
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Demissie M, Molla G, Tayachew A, Getachew F. Risk factors of preeclampsia among pregnant women admitted at labor ward of public hospitals, low income country of Ethiopia; case control study. Pregnancy Hypertens 2021; 27:36-41. [PMID: 34906812 DOI: 10.1016/j.preghy.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 11/09/2021] [Accepted: 12/03/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Preeclampsia is a pregnancy-specific, multisystem disorder of unknown etiology, which characterized by new onset of high blood pressure & proteinuria after 20 weeks of gestation. Globally, it contributes 76,000 maternal deaths, 500,000 infant deaths annually, and the second common cause of maternal deaths. In Ethiopia, 19% of maternal deaths result from hypertensive disorder of Pregnancy. OBJECTIVE To assess the risk factors of preeclampsia among pregnant women admitted in labor ward of Public hospitals, Amhara Region Ethiopia, METHODS: A facility based unmatched case-control study design was conducted in two public hospitals of North Wollo Zone. Cases were pregnant women, who had confirmed diagnosis of preeclampsia, controls were those who had no evidence of preeclampsia, and 65 cases and 195 controls were selected by convenience and systematic random sampling techniques respectively. The collected data was interred in to in EPI INFO version 7.1, transferred, and analyzed using SPSS version 20.00 statistical software. Multivariate logistic regression was used to identify independent variables. Factors with P-value < 0.05 were taken as statistically significant of pre-eclampsia among pregnant women. RESULT All of the respondents of cases and controls were participated in the study. Factors associated with preeclampsia were respondents who had read and write (AOR = 3.22, 95% CI: (1.05-9.84)) and attended primary school [AOR = 7.02, 95% CI: (1.57-31.45)]. Those pregnant women, who had at least two ANC visit [AOR = 8.69, 95%CI: (1.43-52.85)] and those who had three visit [AOR = 12.59, 95%CI: (3.06-56.05)]. In addition to these, birth Interval less than 24 month [AOR = 4.09, 95% CI: (1.33-12.61)]. Birth Interval 24-35 month [AOR = 2.53, 95% CI: (1.38-11.87], respondents with family history of HPN (AOR = 5.93, 95%CI: (2.39-14.67), family history of DM [AOR = 2.15, 95%CI: (1.12-6.98)], and respondents with previous history of preeclampsia (AOR = 4.14 95%CI: (1.66-10.33) were identified significant factors of preeclampsia among pregnant women attended in labour ward. CONCLUSION AND RECOMMENDATION Educational status, antenatal care, lower birth interval, having family history of chronic HPN and DM, and history of preeclampsia were identified as major risk factors for occurrence of preeclampsia. Early detection of cases and intensive screening of pregnant women in every visit should be done and large-scale study will be done to identify other risk factors of preeclampsia.
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Affiliation(s)
| | - Gebeyaw Molla
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Adamu Tayachew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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