Burden and determinants of preeclampsia and eclampsia in Ugandan tertiary healthcare facilities: a systematic review.

Preeclampsia and eclampsia, hypertensive disorders of pregnancy, significantly contribute to maternal and perinatal morbidity and mortality in low- and middle-income countries like Uganda. Comprehensive data on their prevalence and determinants in Uganda's tertiary healthcare facilities are limited. A systematic review was conducted searching PubMed, Lens.org, and Google Scholar for observational studies from Ugandan tertiary hospitals published between January 2015 and March 2025. Due to heterogeneity, a narrative synthesis was performed using the Synthesis without Meta-analysis (SWiM) framework, with study quality assessed via the Newcastle-Ottawa Scale. Ten studies, primarily from Mulago and Mbarara hospitals, met the final inclusion criteria. Limited population-based prevalence data were available, with one study reporting preeclampsia prevalence of 4.3 %. Key determinants included young maternal age, nulliparity, and delayed care-seeking. Complications such as HELLP syndrome (18.6 %) and non-proteinuric preeclampsia (24.6 %) were frequent, with systemic challenges like limited laboratory capacity noted. Preeclampsia and eclampsia impose a substantial burden in Uganda's tertiary facilities, necessitating enhanced antenatal screening and timely referral. The scarcity of standardized prevalence data underscores the need for broader epidemiological surveillance.