Magnitude and determinants of adverse perinatal outcomes of pregnancies complicated with preeclampsia and eclampsia at a teaching hospital in the Tigray region of Ethiopia.

backgroundPreeclampsia-eclampsia (PRE-E) syndrome remains a major global health issue because of its implications as an important cause of severe maternal and neonatal morbidity and mortality. Determining the magnitude of the problem and identifying factors that negatively affect outcomes is vital for clinical decision-making. Identifying high-risk pregnant women who need intensive observation and devising context-specific interventions to reduce unfavorable perinatal outcomes relies on understanding the magnitude and determinant factors. Hence, this study aimed to quantify the magnitude and determinant factors of adverse perinatal outcomes among pregnant women with preeclampsia-eclampsia syndrome at Ayder comprehensive specialized hospital in the Tigray region of Ethiopia.

methodsA cross-sectional study was conducted that included 934 pregnant women who had PRE-E syndrome at Ayder comprehensive specialized hospital from January 1, 2015, to December 31, 2021. Data were collected using EpiData (version 4.6.0.2) and analyzed using Stata version 16. A composite adverse perinatal outcome including fetal growth restriction, preterm birth, low Apgar score at the 5th minute, stillbirth, and neonatal death was calculated and used for analysis. Multivariable logistic regression was performed to identify determinant factors of adverse perinatal outcomes; results are described using adjusted odds ratio (AOR). A p-value less than 0.05 was used to declare a statistically significant difference.

resultsThe prevalence of adverse perinatal outcomes among the study participants was 65.1% (95% CI 61.2, 68.1). The overall perinatal mortality rate was 166 per 1000 live births. Multifetal gestation (AOR = 10.6, 95% CI 4.38, 25.69), primigravidity (AOR = 1.74, 95% CI 1.01,3.00), onset of PRE-E syndrome before 34 weeks (AOR = 29.75, 95% CI 12.8,68.7), and having severity features (AOR = 2.66, 95% CI 1.92,3.66) were significant determinants of adverse perinatal outcomes.

conclusionThe overall prevalence of adverse perinatal outcomes was consistent with countrywide findings and studies done elsewhere in low-resource settings. Early-onset preeclampsia, severe features, multifetal gestation, and primigravidity negatively affected perinatal outcomes. Thus, clinical profiles such as gravidity, gestational age at diagnosis, multifetal gestation, and severity features should be considered in clinical decision-making in low-resource settings. Perinatal outcomes may be improved through optimizing antepartum, intrapartum, and postpartum context- and gestational age-specific interventions, and adhering to established protocols with proven perinatal benefits such as administration of steroids, neuroprotection, and neonatal surfactant use.