Preeclampsia, prevalence and associated factors

Abstract

Background Preeclampsia (PE) is a significant obstetric complication associated with adverse maternal and fetal outcomes. Zambia, like several Sub-Saharan African nations, experiences a high prevalence of pregnancy-related hypertension, with PE being a major contributor to maternal and foetal mortality. This study aimed to identify the factors associated with the development of PE. Methods We conducted a cross-sectional study at Livingstone University Teaching Hospital in Zambia (LUTH). PE was defined as new-onset hypertension with systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg occurring after 20 weeks of gestation, accompanied by proteinuria with dipstick reading of 1 + . Data from patients’ most recent hospital visits was collected by trained research assistants using medical record abstraction. A total of 1018 participants were included. Demographic, clinical, and haematological parameters were analysed. We conducted both descriptive and inferential analyses using Stata version 17. Univariable and multivariable logistic regression were employed to investigate factors associated with PE. Results The median age of participants was 27 years (IQR: 21–33). The prevalence of PE was 12.2% (n = 124). Among the 17.7% (n = 172) of participants who were employed, 19.1% (n = 33) had PE. Factors positively associated with PE included increasing age (Adjusted Odds Ratio [AOR]: 1.07, 95% Confidence Interval [CI]: 1.02–1.12, p = 0.002), a previous history of PE (AOR: 30.8, 95% CI: 8.7–108.6, p < 0.001), and a family history of PE (AOR: 9.97, 95% CI: 2.53–39.27, p = 0.001). Conversely, a unit (week) increase in gestational age was negatively associated with PE (AOR: 0.89, 95% CI: 0.83–0.97, p = 0.007). Conclusion This study identifies maternal age, family history, and prior obstetric history as key associated factors for PE, emphasizing the need for targeted screening and early intervention. Enhanced prenatal care, including routine risk assessments, patient education, and regular monitoring through blood pressure checks, urine protein testing, and fetal growth assessments, is cardinal for early detection and effective management of high-risk individuals.