# 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.

## Key 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.