DETERMINANTS OF (PRE) ECLAMPSIA AMONG WOMEN WHO GAVE BIRTH AT HIWOT FANA COMPREHENSIVE SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA: A CASE-CONTROL STUDY

Abstract

Background: Pre-eclampsia (a new onset of hypertension and proteinuria, or end organ damage after 20 weeks of gestation with or without proteinuria) and eclampsia (occurrence of new onset, generalized, tonic-clonic seizures or coma in a patient with preeclampsia ) are the second causesof maternal mortality and morbidity. It is not only the commonest of cause of maternal problems but also results in high perinatal mortality and morbidity. Since eclampsia is preceded by preeclampsia and shows the progression of the disease, they share the same pathogenesis and determining factors.While the basic etiology of (pre)-eclampsia remained a mystery of medicine, knowledge of the basic determinants is essential for itsprevention and/or its associated consequences.In this study all types of preeclampsia(severe vs non severe) and eclampsia are considered as a case. Objective: To identify determinants of (pre-)eclampsia among women who gave birth in Hiwot Fana Comprehensive Specialized University Hospital from June1, 2020 to August 31, 2023. Methods: An unmatched case-control study was conducted at Hiwot Fana Comprehensive Specialized University Hospital from September 1 to 30, 2023. All women who gave birth at the hospital were considered a source population, while women who gave birth during study period(June1, 2020 to August 30, 2023) constitute study population. Among study populations, women who had (pre)eclampsia were considered as a case, while those without (Pre)eclampsia are considered as a control.The final sample size calculated using EPI Info version 7 for a case control study using the following assumptions: 95% confidence interval, power of 80%, case-to control ratio of 1:2, and 5% non-response rate was 305. Data was collected through chart review filled on Google forma, down loaded with excel format and directly transported to SPSS version 26. Those variables with p value of <0.25 on binary logistic was entered into multivariable logistic regression to identify significant association. Variables with p value of <0.05 was considered as significant and their association was explained using odd ratio and 95% confidence interval. Results:A total of 300 women (100 cases and 200 controls) with a mean age of 24.4 (+SD) years were included in the study. Rural residence (AOR = 2.04, 95% CI = 1.10–3.76), age less than 20 years (AOR = 3.04, 95% CI = 1.58–5.85), history of hypertensive disorders of pregnancy(AOR = 5.52, 95% CI = 1.76–17.33), and no antenatal care(AOR = 2.38, 95% CI = 1.19–4.75) were found to be the determinants of (pre-)eclampsia. x | P a g e Conclusion; We found that living in a rural areas, previous history of (pre)eclampsia, no antenatal care, and <20 years of age were significantly associated with (pre)eclampsia. Younger women and rural residents should be prioritized in (pre)eclampsia screening and/or management.