Maternal Profiles and Associated Outcomes in Preeclampsia: A Five-Year Retrospective Study in a Tertiary Care Center in Saudi Arabia

Introduction: Hypertensive disorders, encompassing chronic hypertension, gestational hypertension, preeclampsia (PE), eclampsia, and superimposed preeclampsia, impact up to 10% of pregnancies globally and contribute to significant maternal and neonatal morbidity and mortality. Aim: This study aimed to compare the clinical characteristics of women with preeclampsia and evaluate the associated maternal and neonatal outcomes across different subtypes of preeclampsia. Patient and Methods: This retrospective study was conducted among patients diagnosed with preeclampsia at the Maternal-Fetal Medicine department in National Guard Health Affairs, Riyadh, Saudi Arabia, between January 2019 and January 2024 (5 years). All pregnant females diagnosed with preeclampsia were involved. Data collected include age, gravity, parity, BMI, antihypertensive medication use, Magnesium sulfate use, type of preeclampsia, history of preeclampsia, length of hospital stay, and neonatal outcomes. Results: Two hundred and seventy-one patients were analyzed and classified into 4 groups: Mild preeclampsia (N=117; 43.2%), severe preeclampsia (N=102; 37.6%), postpartum preeclampsia (N=42; 15.5%), and superimposed preeclampsia (N=10; 3.7%). The mean maternal age was 32 years, and the mean BMI was 31.2 kg/m2. Superimposed preeclampsia was associated with early preterm delivery (p=0.029), and emergency cesarean section (p=0.010). Stillbirth prevalence among PE patients was 5.5% (N=15). Conclusion: Superimposed preeclampsia was associated with adverse maternal outcomes, including lower gestational age at delivery and increased emergency cesarean section rates. However, these findings should be interpreted carefully due to the small sample size of the superimposed preeclampsia subgroup. Stillbirth occurred in 5.5% of cases and was observed among patients with severe preeclampsia; however, no statistically significant difference was identified between groups. Further prospective studies are warranted to better understand these associations and improve maternal and neonatal outcomes. Plain Language Summary: Preeclampsia is a serious condition that can occur during pregnancy. It poses significant risks to both the mother and the neonate. This study reviewed medical records of 271 pregnant women diagnosed with preeclampsia over a period five years. Patients were grouped based on the type of preeclampsia: mild, severe, postpartum, or superimposed preeclampsia. The results showed that women with superimposed preeclampsia had more complications, including lower gestational age at delivery and higher chance of emergency cesarean section. Stillbirth occurred in 5.5% of all cases and was more frequently observed in severe preeclampsia. Understanding how different types of preeclampsia affect outcomes can help guide better monitoring and care for women with this condition.