dc.contributor.author | Ndwiga, Charity | |
dc.contributor.author | Odwe, George | |
dc.contributor.author | Pooja, Sripad | |
dc.contributor.author | Ogutu, Omondi | |
dc.contributor.author | Osoti, Alfred | |
dc.contributor.author | Warren, Charlotte E | |
dc.date.accessioned | 2021-08-27T12:56:51Z | |
dc.date.available | 2021-08-27T12:56:51Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | Ndwiga C, Odwe G, Pooja S, Ogutu O, Osoti A, E Warren C. Clinical presentation and outcomes of pre-eclampsia and eclampsia at a national hospital, Kenya: A retrospective cohort study. PLoS One. 2020 Jun 5;15(6):e0233323. doi: 10.1371/journal.pone.0233323. PMID: 32502144; PMCID: PMC7274433. | en_US |
dc.identifier.uri | https://pubmed.ncbi.nlm.nih.gov/32502144/ | |
dc.identifier.uri | http://erepository.uonbi.ac.ke/handle/11295/155365 | |
dc.description.abstract | Background: Hypertensive disorders in pregnancy including pre-eclampsia are associated with maternal and newborn mortality and morbidity. Early detection is vital for effective treatment and management of pre-eclampsia. This study examines and compares the clinical presentation and outcomes between early- and late-onset pre-eclampsia over a two year period.
Methods: A retrospective cohort study design which examines socio-demographic characteristics, treatment, outcomes, and fetal and maternal complications among women with early onset of pre-eclampsia (EO-PE) and late onset of pre-eclampsia (LO-PE). De-identified records of women who attended antenatal, intrapartum and postnatal care services and experienced pre-eclampsia at Kenyatta National teaching and referral hospital were reviewed. We used chi square, t-test, and calculated odds ratio to determine any significant differences between the EO-PE and LO-PE cohorts.
Results: Out of 620 pre-eclamptic and eclamptic patients' records analyzed; 44 percent (n = 273) exhibited EO-PE, while 56 percent had late onset. Women with EO-PE compared to LO-PE had greater odds of adverse maternal and perinatal outcomes including hemolysis elevated liver enzymes and low platelets (HELLP) syndrome (OR: 4.3; CI 2.0-10.2; p<0.001), renal dysfunction (OR; 1.7; CI 0.7-4.1; p = 0.192), stillbirth (OR = 4.9; CI 3.1-8.1; p<0.001), and neonatal death (OR: 8.5; CI 3.8-21.3; p<0.001). EO-PE was also associated with higher odds of prolonged maternal hospitalization, beyond seven days (OR = 5.8; CI 3.9-8.4; p<0.001), and antepartum hemorrhage (OR = 5.8; CI 1.1-56.4; p<0.001). Neonates born after early onset of pre-eclampsia had increased odds of respiratory distress (OR = 17.0; CI 9.0-32.3, p<0.001) and birth asphyxia (OR: 1.9; CI 0.7-4.8; p = 0.142).
Conclusions: The profiles and outcomes of women with EO-PE (compared to late onset) suggest that seriousness of morbidity increases with earlier onset. To reduce adverse neonatal and maternal outcomes, it is critical to identify, manage, referral and closely follow-up pregnant women with pre-eclampsia throughout the pregnancy continuum. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.subject | pre-eclampsia, eclampsia, retrospective cohort | en_US |
dc.title | Clinical presentation and outcomes of pre-eclampsia and eclampsia at a national hospital, Kenya: A retrospective cohort study | en_US |
dc.type | Article | en_US |