Risks of adverse perinatal and maternal outcomes among women with hypertensive disorders of pregnancy in southwestern Uganda.
Risks of adverse perinatal and maternal outcomes among women with hypertensive disorders of pregnancy in southwestern Uganda.
复制标题
DOI：
10.1371/journal.pone.0241207
复制
发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Boatin AA
中科院分区：
文献类型：
--
作者：
Lugobe HM;Muhindo R;Kayondo M;Wilkinson I;Agaba DC;McEniery C;Okello S;Wylie BJ;Boatin AA
Hypertensive disorders of pregnancy (HDP) are a leading cause of global perinatal (fetal and neonatal) and maternal morbidity and mortality. We sought to describe HDP and determine the magnitude and risk factors for adverse perinatal and maternal outcomes among women with HDP in southwestern Uganda. We prospectively enrolled pregnant women admitted for delivery and diagnosed with HDP at a tertiary referral hospital in southwestern Uganda from January 2019 to November 2019, excluding women with pre-existing hypertension. The participants were observed and adverse perinatal and maternal outcomes were documented. We used multivariable logistic regression models to determine independent risk factors associated with adverse perinatal and maternal outcomes. A total of 103 pregnant women with a new-onset HDP were enrolled. Almost all women, 93.2% (n = 96) had either pre-eclampsia with severe features or eclampsia. The majority, 58% (n = 60) of the participants had an adverse perinatal outcome (36.9% admitted to the neonatal intensive care unit (ICU), 20.3% stillbirths, and 1.1% neonatal deaths). Fewer participants, 19.4% (n = 20) had an adverse maternal outcome HELLP syndrome (7.8%), ICU admission (3%), and postpartum hemorrhage (3%). In adjusted analyses, gestational age of < 34 weeks at delivery and birth weight <2.5kg were independent risk factors for adverse perinatal outcomes while referral from another health facility and eclampsia were independent risk factors for adverse maternal outcomes. Among women with HDP at our institution, majority had preeclampsia with severe symptoms or eclampsia and an unacceptably high rate of adverse perinatal and maternal outcomes; over a fifth of the mothers experiencing stillbirth. This calls for improved antenatal surveillance of women with HDP and in particular improved neonatal and maternal critical care expertise at delivering facilities. Earlier detection and referral, as well as improvement in initial management at lower level health units and on arrival at the referral site is imperative.
登录
查看更多内容
影响因子：
3.1
作者：
Ngonzi, Joseph;Tornes, Yarine Fajardo;Van Geertruyden, Jean-Pierre
通讯作者：
Van Geertruyden, Jean-Pierre
影响因子：
4.8
作者：
Norton, Edward C.;Miller, Morgen M.;Kleinman, Lawrence C.
通讯作者：
Kleinman, Lawrence C.
DOI：
10.1016/j.ijgo.2014.06.010
发表时间：
2014-12-01
影响因子：
3.8
作者：
Adu-Bonsaffoh, Kwame;Obed, Samuel A.;Seffah, Joseph D.
通讯作者：
Seffah, Joseph D.
DOI：
10.1111/1471-0528.12629
发表时间：
2014-03-01
影响因子：
5.8
作者：
Abalos, E.;Cuesta, C.;Souza, J. P.
通讯作者：
Souza, J. P.
影响因子：
2.8
作者：
Li, Xun;Zhang, Weishe;Xia, Lu
通讯作者：
Xia, Lu