Association of risk factors, clinical presentation, and treatment with neonatal outcomes among pre-eclamptic and eclamptic women: a cross-sectional study.

BACKGROUND

Eclampsia and pre-eclampsia cause high feto-maternal mortality in Pakistan. This study aimed to identify potential risk factors in pregnant women that can lead to the development of eclampsia and pre-eclampsia.

METHODS

A cross-sectional study was conducted in the BVH, Bahawalpur (July 2021-December 2022), to record socio-demographic information, risk factors, clinical symptoms, and treatment administered, which was linked with maternal and neonatal outcomes. The Chi-squared test was applied to describe the relation in categorical variables. Odds ratio were calculated by binary logistic regression for normally distributed significant values.

RESULTS

A total of 85 women with eclampsia and 43 with pre-eclampsia were included in the study. The eclamptic women showed a higher rate of illiteracy, were overweight, and married to their cousins. They presented with high systolic blood pressure, proteinuria, and low platelet count (OR = 7.24, 95% CI = 1.60-32.68, p = 0.01), increased respiratory rate, and elevated AST, ALT, and LDH levels at the time of diagnosis. Women administered with MgSO4 10 g/day (48.5% survived vs. 77.4% non-survived) showed high perinatal mortality compared to a 4 g/day dose (30.9% survived vs. 16.1% non-survived) or those who hadn't received magnesium sulfate (20.6% survived vs. 6.5% non-survived).

CONCLUSION

Advanced maternal age (≥35), overweight, elevated AST, ALT, and LDH levels, consanguinity, and grand multiparity were associated with higher perinatal mortality. Women with these predictive factors should be monitored for the development of pre-eclampsia or eclampsia.