Maternal Outcome and Associated Factor of Severe Preeclampsia among Women Admitted at Asella Referral and Teaching Hospital, Oromia, Ethiopia, 2024

Abstract

Background: Preeclampsia is a significant pregnancy complication characterized by high blood pressure and proteinuria. Severe preeclampsia is a more advanced stage of the condition and is associated with heightened risks for both the mother and the fetus. Understanding maternal outcomes and the factors associated with severe preeclampsia is crucial for effective management and improving overall outcomes.

Objective: To assess maternal outcomes and factors associated with severe preeclampsia among patients admitted to Asella Referral and Teaching Hospital from August 1, 2024, to December 30, 2024.

Methods: A hospital-based cross-sectional study was conducted to evaluate maternal outcomes and associated factors of severe preeclampsia at Asella Referral and Teaching Hospital in 2024. All cases of preeclampsia with severe features (PEWSF) after 28 weeks of gestation were prospectively registered. Data were collected using a structured, pre-tested questionnaire via face-to-face interviews and clinical chart reviews. Data were entered into EpiData V.4.6 and analyzed using SPSS V.25.0 statistical software. Binary logistic regression analysis was used to assess the association between independent and dependent variables, presenting both crude and adjusted odds ratios. Variables with p-values <0.05 at a 95% confidence interval were considered potential determinants of adverse maternal outcomes.

Results: A total of 362 respondents participated in the study, yielding a 95.26% response rate. The mean age of the participants was 27.26 ± 4.94 years. The prevalence of unfavorable maternal outcomes was 34.8% (95% CI: 34.59–35.01). The most common unfavorable outcomes were abruptio placenta (28.6%), HEELP syndrome (26.2%), and postpartum hemorrhage (PPH) (10.2%). Factors significantly associated with unfavorable maternal outcomes included maternal age (35–44 years) (AOR 1.41 [95% CI: 1.01–4.19]), nulliparity (AOR 1.51 [95% CI: 1.04–5.16]), high BMI (≥30) (AOR 1.63 [95% CI: 1.12–6.20]), severe hypertension at admission (AOR 1.46 [95% CI: 1.02–3.67]), a history of preeclampsia (AOR 2.07 [95% CI: 1.09–4.84]), and the presence of headaches at admission (AOR 1.79 [95% CI: 1.01–4.72]).

Conclusion: The prevalence of unfavorable maternal outcomes among women with severe preeclampsia in Asella Referral and Teaching Hospital is high. The most common unfavorable outcomes were abruptio placenta, HEELP syndrome, and PPH. Maternal age, nulliparity, high BMI, severe hypertension at admission, a history of preeclampsia, and the presence of headaches at admission were significantly associated with adverse maternal outcomes. Therefore, promoting socioeconomic development and ensuring early recognition of the severe signs and symptoms of preeclampsia are essential steps to reducing these adverse outcomes.