Risk factors for preeclampsia and eclampsia in Sidama region, southern Ethiopia: a nested case-control study

ABSTRACT

Introduction: though Ethiopia has made a significant improvement in the reduction of maternal mortality, the high burden of preeclampsia remains a concern in the Sidama region of southern Ethiopia. This study aimed to determine the risk factors for preeclampsia and eclampsia in the Sidama region of southern Ethiopia. Methods: a nested case-control study was conducted from August 8, 2019, to October 1, 2020 in the Sidama region. Two-stage sampling techniques were used to recruit study participants. First, seven of the 13 public hospitals were selected using a random sampling technique. Second, cases and controls were selected from a cohort of pregnant women enrolled at ≥20 weeks of gestation up until the 37th week. Data were collected in a face-to-face interview using a locally translated and validated tool. Binary logistic regression analysis was used to identify risk factors for preeclampsia and eclampsia Results: of the planned sample size of 816 women, we enrolled 808 (404 cases and 404 controls). Of the 404 cases, (59.40%, 240/404) had preeclampsia without severity features, (30.94%, 125/404) had preeclampsia with severity features, and (9.65%, 39/404) had convulsions. After controlling for confounders, women having a low wealth status were 98% [AOR 1.98, 95%CI 1.34-2.92] at higher risk for preeclampsia and eclampsia compared to women having a high wealth status. Women who had early neonatal deaths were 5 times more likely to be developed preeclampsia and eclampsia than women who did not have early neonatal deaths [AOR 5.09, 95%CI 1.69-9.36]. Women who did not attend school were three times more likely to develop preeclampsia and eclampsia [AOR 3.00, 95% CI 1.10-8.19] compared to women who attended college/university. Conclusion: in this study, a higher risk for preeclampsia and eclampsia was observed among women with low wealth status, women who had early neonatal deaths and women who did not attend school. Some of these factors could be positively influenced by educational interventions. Maternal and child health providers should screen pregnant women at risk for preeclampsia and eclampsia using these factors. Findings of this study will provide epidemiological evidence for policy makers and implementers to reduce the occurrence of preeclampsia and eclampsia.