Observational studyBMC pregnancy and childbirth2025
HELLP syndrome as a major contributor to adverse maternal and neonatal outcomes among preeclamptic women: findings from a multicenter retrospective cohort study.
Observational study in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Association between urinary neutrophil gelatinase-associated lipocalin and severe preeclampsia among pregnant women in Kinshasa: a multicenter-based cross-sectional study.BMC pregnancy and childbirth · 2026Article
- Independent factors associated with renal impairment in preeclampsia and its association with maternal and neonatal adverse outcomes.Frontiers in medicine · 2026Article
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9 authors.
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Abstract
objectiveHELLP syndrome, a severe complication of preeclampsia, is associated with increased maternal and neonatal morbidity and mortality. This study aims to evaluate maternal and perinatal outcomes in preeclamptic women with and without HELLP syndrome in Indonesia.
methodsA multicenter retrospective cohort study was conducted across 30 hospitals in Indonesia from January 2022 to December 2023. Data from 1,808 preeclamptic women were analyzed, with 219 (12.1%) classified as having HELLP syndrome. Maternal and perinatal outcomes were compared between the HELLP and non-HELLP groups.
resultsWomen with HELLP syndrome had significantly higher risks of severe complications, including eclampsia (p < 0.001; aOR: 2.5 (1.5-4.18)), acute kidney injury (p < 0.01; aOR: 4.11 (2.07-8.15)), emergency hypertension (p = 0.048; aOR: 1.42 (1.01-2.01)), preterm birth < 37 weeks (p = 0.013; aOR: 1.54 (1.1-2.17)), and preterm birth < 34 weeks (p < 0.001; aOR: 1.8 (1.28-2.53)). HELLP syndrome increased the risk of Intra-uterine fetal death (p = 0.01; aOR: 2.18 (1.21-3.95)) and neonatal sepsis (p = 0.011; aOR: 2.32 (1.21-4.42)). Although the multivariate analysis did not yield any significant results, the HELLP syndrome group has a substantially higher prevalence of maternal death (3.7% vs 1%; p = 0.005) and neonatal death (11.6% vs 6.4%; p = 0.005).
conclusionHELLP syndrome significantly worsens maternal and neonatal outcomes in preeclampsia, reflecting a need for improved early detection of 'high-risk' preeclamptic women like sFlt1/PLGF ratio and perhaps other laboratory tests like haptoglobin and D-dimer's. Many of these laboratory tests are currently not accessible in the Indonesian public health sector. Further research is needed to identify other markers that would assist in a more timely diagnosis of impending HELLP syndrome, particularly in early-onset preeclampsia patients managed conservatively.
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