To Find the Association Between Clinical and Demographic Risk Factors and Development of Pre-Eclampsia

Author(s): Richa Sharma, Nupur Sharma, Shivangi Gupta, Manas Ranjan Moharana

Background: Hypertensive disorders of pregnancy are an important cause of maternal and perinatal morbidity and mortality in developing countries like India. It is one of the leading causes of maternal and perinatal mortality and morbidity worldwide.

Aims: The current study will study a wide range of maternal demographic, socio- economic, obstetric, nutritional, and anthropometric parameters risk factors for pre- eclampsia in a tertiary hospital and assess their level of association so as to find the best predictors of pre-eclampsia.

Methods and Materials: This retrospective study done in Department of Obstetrics & Gynecology of Dr. Baba Saheb Ambedkar Medical College & Hospital, New Delhi, for period of one years. In the present study, we analyzed forty-three clinico-demographic risk factors of preeclampsia and a significant association was found with twenty-nine of these. The present study found seven independent predictors of preeclampsia - mental stress (PSS), maternal hypothyroidism, family history of preeclampsia, previous history of hypertension disorder in previous pregnancy, gestational diabetes mellitus, non-veg food habit and autoimmune disorder. A risk factor-based prediction model and scoring system developed using the independent predictors has high sensitivity and specificity for preeclampsia risk prediction in a heavy antenatal OPD in resource constraint government hospitals.

Results- Risk of pre-eclampsia was lower in age group 21-30 years and 31-40 years. Multigravida, longer duration of cohabitation (years) has lower risk of pre-eclampsia. Period of gestation (weeks) in cases, season of conception and the month of preeclampsia in pregnant women and sex of baby has no significant association with preeclampsia. Women with longer inter pregnancy interval (years), who conceived with ART, high BMI, high mean arterial pressure, more gestational weight gain (kg), history of hypertensive disorder, GDM, multi fetal pregnancy and raised lipid profile had high risk of pre-eclampsia. Women with change of paternity was higher in group A as compared to group B (19.64% vs 7.14% respectively) (p value =0.006). Women with high haemoglobin (g/dL) had significantly low risk of pre-eclampsia. (p value <.0001). PCOS, CKD, family history of CVS, non-veg diet, maternal hypothyroid, autoimmune disease, chronic hypertension and mental disorders was significantly higher in group A as compared to group B. Distribution of smoking habit (p value=0.469), history of urinary tract infection (p value=0.298), blood group (p value- 0.136) and Rh factor (p value=0.498) no significant association of these factors were established in our study. Perceived stress scale in group A was 30(28-34.25) which was significantly higher as compared to group B (16(15-17)) (p value <.0001).

Conclusion- The present study found seven independent predictors of preeclampsia - mental stress (PSS), maternal hypothyroidism, family history of preeclampsia, previous history of hypertension disorder in previous pregnancy, gestational diabetes mellitus, non-veg food habit and autoimmune disorder. A risk factor-based prediction model and scoring system developed using the independent predictors has high sensitivity and specificity for preeclampsia risk prediction in a heavy antenatal OPD in resource constraint government hospitals.