Adverse Materno-Foetal Outcomes of Pre-Eclampsia at a Rural Tertiary Hospital in the Eastern Cape Province of South Africa

TL;DR

This study examines the maternal and fetal risks of pre-eclampsia in a rural South African hospital, finding significant adverse outcomes like low birth weight and preterm delivery.

Contribution

The study provides insights into pre-eclampsia outcomes in a rural Sub-Saharan African setting, emphasizing the need for early antenatal care.

Findings

Pre-eclampsia is strongly associated with low birth weight and fetal distress.

Maternal outcomes include HELLP syndrome and preterm delivery.

Early antenatal care and monitoring are critical to reducing adverse outcomes.

Abstract

Pre-eclampsia affects several physiological systems, often changing the course of pregnancy and manifesting with both maternal and foetal adversities, with a higher burden in rural Sub-Saharan African settings. This study presents maternal and foetal adverse outcomes associated with pre-eclampsia at a rural tertiary hospital in the Eastern Cape Province of South Africa. A prospective analytical case-control study was conducted with 250 pregnant women planned for delivery at the study setting’s labour unit. Pregnant women with pre-eclampsia were considered cases, whereas pregnant women without pre-eclampsia were considered controls. Cases were enrolled first, followed by a matched pair of controls based on their gravidity. A consecutive sampling technique was used to recruit eligible cases and controls. Data was collected using a self-designed questionnaire followed by descriptive and inferential analysis. Adverse foetal outcomes associated with pre-eclampsia were low birth weight [Adjusted odds ratio (AOR) = 2.1, p = 0.006] and foetal distress (AOR = 2.5, p < 0.001). Maternal outcomes associated with pre-eclampsia were haemolysis, elevated liver enzymes, and low platelets syndrome (AOR = 42.7, p < 0.001), as well as preterm delivery (AOR = 3.0, p = 0.001). Early antenatal visits, continuous monitoring of pre-eclamptic pregnant women, and implementation of preventive and curative measures to reduce the possibilities of this condition and its adverse outcomes are needed.

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