Gestational Age–Specific Prevalence of Preeclampsia Among Pregnant Women in Ghana: A Hospital-Based Retrospective Observational Study

TL;DR

This study found that preeclampsia is most common at full-term in Ghanaian pregnancies and is linked to maternal age, prior C-sections, and early gestation.

Contribution

The study reports the first gestational age–specific prevalence of preeclampsia in Ghana and identifies key risk factors.

Findings

The overall preeclampsia prevalence was 10.5% among 619 pregnant women.

Preeclampsia was most prevalent at 39–40 weeks (4.0%) and least at ≥42 weeks (0.5%).

Maternal age 30–39 years, prior C-section, and gestation <37 weeks were significant risk factors.

Abstract

Background: Preeclampsia is responsible for a significant rate of maternal morbidity and mortality worldwide. Gestational age as a risk factor has a significant impact on fetal outcomes in pregnancies affected by preeclampsia. However, to our knowledge, no study has identified the gestational age–specific prevalence of preeclampsia in Ghana. Thus, this study ascertained the gestational age–specific prevalence of preeclampsia as well as its associated factors.

Methods: A hospital-based retrospective observational study was conducted by reviewing data collected from the maternal birth register on 619 pregnant women who delivered at the facility from 1st January 2021 to 31st December 2021.

Results: Out of 619 pregnant women, the overall prevalence of preeclampsia among the study participants was 10.5% whereas 80.5% were normotensive pregnant women. The gestational age–specific prevalence of preeclampsia was 2.3%, 2.1%, 4.0%, 1.6%, and 0.5% at < 37 weeks, 37–38 weeks, 39–40 weeks, 41 weeks, and ≥ 42 weeks, respectively. Most of the mothers who had preeclampsia were within the age group of 30–39 years (40, 61.5%), had informal education (41, 64.1%), and were multigravida (40, 61.5%). Age group 30–39 years (aOR = 2.49, 95% CI (1.25–4.96), p = 0.0090), C/S (aOR = 2.83, 95% CI (1.46–5.50), p = 0.0020), and gestational age category < 37 weeks (aOR = 0.24, 95% CI (0.07–0.78), p ≤ 0.0140) and 37–38 weeks (aOR = 0.23, 95% CI (0.08–0.66), p = 0.0060) were the independent predictors of preeclampsia, respectively, with head circumference < 33 cm (aOR = 2.09, 95% CI (1.00–4.37), p = 0.0490) as the independent complication associated with it.

Conclusions: Gestational age–specific prevalence of preeclampsia is high at full-term (39–40 weeks) gestation. Independent risk factors for preeclampsia included maternal age (30–39 years), gestational age (< 37 weeks), and previous caesarean section. Babies of women with preeclampsia are likely to have a small head circumference.

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