DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20170960

A study in Bundelkhand region of Madhya Pradesh, India to assess the risk factors and correlates of pre-eclamptic toxemia

Shikha Pandey, Ramesh Pandey

Abstract


Background: Pre-eclamptic toxemia is pregnancy-induced hypertension (PIH) manifesting in second trimester and affecting multiple systems. The objective was to study the factors of pre-eclampsia in pregnant women admitted for delivery in Bundelkhand Medical college hospital Sagar, Madhya Pradesh, India.

Methods: A case-control study was conducted at Bundelkhand Medical College Hospital in Sagar, Madhya Pradesh, India. Criteria in selection of pregnant women with pre-eclampsia comprised those who had hypertension after the 20th week of gestation with associated proteinuria, and controls were pregnant women who were not diagnosed with pre-eclampsia. Total of 100 cases and 100 controls were selected for the year 2015. Factors in study included mother's age, parity, body mass index, history of chronic hypertension, history of diabetes, history of renal disease, family history of hypertension, and history of pre-eclampsia in earlier pregnancy. Crude and adjusted odds ratio with 95% CI and Chi-square test were used for statistical analysis.

Results: Major risk factors identified in univariate analysis included before pregnancy body mass index (BMI >25) (OR=11.27), history of hypertension (OR=8.65), history of diabetes mellitus (OR=11.0), history of renal disorders (OR=7.98), familial history of hypertension (OR=5.4), history of PIH in earlier pregnancy (OR=9.63), and twin pregnancy (OR=4.85). As per multiple logistic regression analysis the pre-pregnancy BMI of >25 (OR=7.56), history of hypertension (OR=6.69), history of diabetes mellitus (OR=8.66), history of renal disease (OR=5.6), family history of hypertension (OR=5.48), and twin pregnancy (OR=5.73) are the significant risk factors of pre-eclampsia.

Conclusions: The pregnant women at risk of pre-eclampsia should be identified early and high-quality antenatal care should be provided in order to minimize the complications of pre-eclampsia both for the mother and the fetus.

 


Keywords


Antenatal care, Case control study, Pre-eclampsia, Risk factors, Twin pregnancy

Full Text:

PDF

References


Geographic variation in the incidence of hypertension in pregnancy. World Health Organization International Collaborative Study of Hypertensive Disorders of Pregnancy. Am J Obstet Gynecol. 1988;158(1):80-3.

Lee CJ, Hsieh TT, Chiu TH, Chen KC, Lo LM, Hung TH. Risk factors for pre-eclampsia in an Asian population. Int J Gynaecol Obstet. 2000;70(3):327-33.

Eskenazi B, Fenster L, Sidney S. A multivariate analysis of risk factors for preeclampsia. JAMA. 1991;266(2):237-41.

Mahomed K, Williams MA, Woelk GB, Jenkins-Woelk L, Mudzamiri S, Madzime S, et al. Risk factors for preeclampsia-eclampsia among Zimbabwean women: Recurrence risk and familial tendency towards hypertension. J Obstet Gynaecol. 1998;18:218-22.

Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005;330(7491):565.

Amir A, Mohd Y, Islam HM. Clinico epidemiological study of factors associated with pregnancy induced hypertension. Indian J community Med. 1998;23:25-9.

Thadhani R, Stampfer MJ, Hunter DJ, Manson JE, Solomon CG, Curhan GC. High body mass index and hypercholesterolemia: risk of hypertensive disorders of pregnancy. Obstet Gynecol. 1999;94(4):543-50.

Davies AM, Czaczkes JW, Sadovsky E, Prywes R, Weiskopf P, Sterk VV. Toxemia of pregnancy in Jerusalem. I. Epidemiological studies of a total community. Isr J Med Sci. 1970;6(2):253-66.

Qiu C, Williams MA, Leisenring WM, Sorensen TK, Frederick IO, Dempsey JC, et al. Family history of hypertension and type 2 diabetes in relation to preeclampsia risk. Hypertension. 2003;41(3):408-13.

Ness RB, Markovic N, Bass D, Harger G, Roberts JM. Family history of hypertension, heart disease, and stroke among women who develop hypertension in pregnancy. Obstet Gynecol. 2003;102(6):1366-71.

Bryson CL, Ioannou GN, Rulyak SJ, Critchlow C. Association between gestational diabetes and pregnancy-induced hypertension. Am J Epidemiol. 2003;158(12):1148-53.

Davies AM, Czaczkes JW, Sadovsky E, Prywes R, Weiskopf P, Sterk VV. Toxemia of pregnancy in Jerusalem. I. Epidemiological studies of a total community. Isr J Med Sci. 1970;6(2):253-66.

Coonrod DV, Hickok DE, Zhu K, Easterling TR, Daling JR. Risk factors for preeclampsia in twin pregnancies: a population-based cohort study. Obstet Gynecol. 1995;85(5 Pt 1):645-50.

Lawoyin TO, Ani F. Epidemiologic aspects of pre-eclampsia in Saudi Arabia. East Afr Med J. 1996;73(6):404-6.