Clinical presentation, maternal-fetal, and neonatal outcomes of early-onset versus late onset preeclampsia-eclampsia syndrome in a teaching hospital in a low-resource setting: A retrospective cohort study

Pre-eclampsia-eclampsia syndrome remains the leading cause of maternal and neonatal mortality worldwide. Both from pathophysiologic and clinical stand points, early and late onset preeclampsia are thought to be two different disease entities. However, the magnitude of preeclampsia-eclampsia and mate...

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Bibliographic Details
Published in:PloS one 2023-02, Vol.18 (2), p.e0281952-e0281952
Main Authors: Teka, Hale, Yemane, Awol, Abraha, Hiluf Ebuy, Berhe, Ephrem, Tadesse, Habtom, Gebru, Fanos, Yahya, Mohammedtahir, Tadesse, Ytbarek, Gebre, Daniel, Abrha, Marta, Tesfay, Bisrat, Tekle, Ashenafi, Gebremariam, Tsega, Amare, Birhane, Ebrahim, Mohamedawel Mohamedniguss, Zelelow, Yibrah Berhe, Mulugeta, Afework
Format: Article
Language:English
Subjects:
Age
Apgar score
Biology and Life Sciences
Birth weight
Blood pressure
Blood tests
Chi-square test
Cohort analysis
Complications and side effects
Computer and Information Sciences
Creatinine
Death
Eclampsia - epidemiology
Edema
Female
Fetuses
Gestational age
Gynecology
Headaches
Health aspects
Health risks
Hospitals, Teaching
Humans
Hypertension
Hypertension in pregnancy
Infant mortality
Infant, Newborn
Infants
Infants (Newborn)
Laboratories
Late Onset Disorders
Liver diseases
Low birth weight
Maternal mortality
Medicine and Health Sciences
Morbidity
Mortality
Mothers
Neonates
Newborn babies
Obstetrics
Patient outcomes
Pre-eclampsia
Pre-Eclampsia - epidemiology
Preeclampsia
Pregnancy
Pregnant women
Prenatal care
Prevention
Regression analysis
Retrospective Studies
Risk factors
Teaching hospitals
Womens health
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Summary:Pre-eclampsia-eclampsia syndrome remains the leading cause of maternal and neonatal mortality worldwide. Both from pathophysiologic and clinical stand points, early and late onset preeclampsia are thought to be two different disease entities. However, the magnitude of preeclampsia-eclampsia and maternal-fetal and neonatal outcomes of early and late onset preeclampsia are not adequately investigated in resource-limited settings. This study sought to examine the clinical presentation and maternal-fetal and neonatal outcome of these two entities of the disease in Ayder comprehensive specialized hospital, an academic setting in Tigray, Ethiopia, from January 1, 2015-December 31, 2021. A retrospective cohort design was employed. The patient charts were reviewed to see the baseline characteristics and their progress from the onset of the disease in the antepartum, intrapartum and postpartum periods. Women who developed pre-eclampsia before 34 weeks of gestation were defined as having early-onset pre-eclampsia, and those who developed at 34 weeks or later were identified as late-onset preeclampsia. We used chi-square, t-test and multivariable logistic regression analyses to determine differences between early- and late onset diseases in terms of clinical presentation, maternal-fetal, and neonatal outcomes. Among the 27,350 mothers who gave birth at the Ayder comprehensive specialized hospital, 1095 mothers had preeclampsia-eclampsia syndrome, with a prevalence of 4.0% (95% CI: 3.8, 4.2)]. Of the 934 mothers analyzed early and late onset diseases accounted for 253 (27.1%) and 681 (72.9%) respectively. Overall, death of 25 mothers was recorded. Women with early onset disease had significant unfavorable maternal outcomes including having preeclampsia with severity features (AOR = 2.92, 95% CI: 1.92, 4.45), liver dysfunction (AOR = 1.75, 95% CI: 1.04, 2.95), uncontrolled diastolic blood pressure (AOR = 1.71, 95% CI: 1.03, 2.84), and prolonged hospitalization (AOR = 4.70, 95% CI: 2.15, 10.28). Similarly, they also had increased unfavorable perinatal outcomes, including the APGAR score at the 5th minute (AOR = 13.79, 95% CI: 1.16, 163.78), low birth weight (AOR = 10.14, 95% CI 4.29, 23.91), and neonatal death (AOR = 6.82, 95% CI: 1.89, 24.58). The present study highlights the clinical differences between early versus late onset preeclampsia. Women with early-onset disease are at increased levels of unfavorable maternal outcomes. Perinatal morbidity and mortality were a
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0281952