Key result
Early-onset non-severe preeclampsia linked to ~422% higher odds of adverse maternal outcomes versus late-onset disease.
Why the study?
Pregnant women with preeclampsia without severe features are at increased risk of adverse maternal and perinatal complications, but outcomes in this group are not well characterized in urban Ethiopia.
Observational (n=164)
No
Odds Ratio: 5.22 (95% CI 2.01–13.6)
Absolute Event Rate: 57.6% vs 21.4%
p-value: p=<0.0001
Expectant outpatient management of preeclampsia without severe features with once-weekly visits in a resource-limited setting is associated with high maternal and perinatal morbidity, particularly in early-onset disease.
Weekly outpatient monitoring of preeclampsia without severe features was associated with high complication rates in Ethiopia; leaves open optimal expectant management strategies.
BACKGROUND: Preeclampsia refers to the new onset of hypertension and proteinuria after 20 weeks of gestation in a previously normotensive woman. Pregnant women with preeclampsia are at an increased risk of adverse maternal, fetal and neonatal complications. The objective of the study is, therefore, to determine the maternal and perinatal outcome of preeclampsia without severity feature among women managed at a tertiary referral hospital in urban Ethiopia. METHODS: A hospital-based prospective observational study was conducted to evaluate the maternal and perinatal outcome of pregnant women who were on expectant management with the diagnosis of preeclampsia without severe feature at a referral hospital in urban Ethiopia from August 2018 to January 2019. RESULTS: There were a total of 5400 deliveries during the study period, among which 164 (3%) women were diagnosed with preeclampsia without severe features. Fifty-one (31.1%) patients with preeclampsia without severe features presented at a gestational age between 28 to 33 weeks plus six days, while 113 (68.9%) presented at a gestational age between 34 weeks to 36 weeks. Fifty-two (31.7%) women had maternal complication of which, 32 (19.5%) progressed to preeclampsia with severe feature Those patients with early onset of preeclampsia without severe feature were 5.22 and 25.9 times more likely to develop maternal and perinatal complication respectively compared to late-onset after 34 weeks with P-value of <0.0001, (95% CI 2.01-13.6) and <0.0001(95% CI 5.75-115.6) respectively. CONCLUSION: In a setting where home-based self-care is poor expectant outpatient management of preeclampsia without severe features with a once per week visit is not adequate. It's associated with an increased risk of maternal and perinatal morbidity and mortality. Our findings call for special consideration and close surveillance of those women with early-onset diseases.
No takes yet. Share an insight, caveat, or question.
Tolu et al. (2020) conducted an observational in Preeclampsia without severe features (n=164). Early-onset preeclampsia without severe features (28-34 weeks) vs. Late-onset preeclampsia without severe features (34-36 weeks) was evaluated on Adverse maternal outcome (AOR 5.22, 95% CI 2.01-13.6, p=<0.0001). Early-onset preeclampsia without severe features significantly increased the odds of adverse maternal (OR 5.22) and perinatal complications (OR 25.9) compared to late-onset disease.