Family history of chronic illness, preterm gestational age and smoking exposure before pregnancy increases the probability of preeclampsia in Omo district in southern Ethiopia: a case-control study

Abstract

Background: Preeclampsia is a complex syndrome that is considered a disorder specific to pregnancy. However, research indicates that diffuse maternal endothelial damage may persist after childbirth. On the other hand, women who had a history of pre-eclampsia are at an increased risk of vascular disease. Considering that the multifactorial nature of pre-eclampsia in a remote health setting, knowledge of risk factors of preeclampsia gives epidemiological significance specific to the study area. Therefore, this study aimed to identify the determinants of preeclampsia among pregnant women attending perinatal service in Omo district Hospitals in southern Ethiopia. Methods: An institution-based unmatched case-control study design was conducted among women visiting for perinatal service in Omo District public hospitals between February to August 2018. A total of 167 cases and 352 controls were included. Data were collected via face-to-face interviews. Bivariable and multivariable logistic regression analysis were computed to examine the effect of the independent variable on preeclampsia using Statistical Package for Social Sciences version 26 window compatible software. Variables with a p-value of less than 0.05 were considered statistically significant. Results: Factors that were found to have a statistically significant association with pre-eclampsia were primary relatives who had history of chronic hypertension (AOR 2.1, 95% CI: 1.06-4.21), family history of diabetes mellitus (AOR 2.35; 95% CI: 1.07-5.20), preterm gestation(AOR = 1.56, 95%CI, 1.05-2.32), and pre-conception smoking exposure (AOR = 4.16, 95%CI, 1.1-15.4). Conclusions: The study identified the risk factors for pre-eclampsia. Early detection and timely intervention to manage pre-eclampsia, and obstetric care providers need to emphasize women at preterm gestation and a history of smoking before pregnancy.

Accuracy of Second Trimester Prediction of Preterm Preeclampsia by Three Different Screening Algorithms

“…10 But it was in agreement with two studies results, which found a significant increase of CS among PE females when compared to females without PE. 12,13 Current study reported that there was a significant decrease of GA at delivery among females with PE. Preeclampsia could be early preterm onset when diagnosed before 34 week gestation, late preterm onset if diagnosed from 34 to 37 weeks, and term onset when diagnosed at or beyond 37 weeks.…”

The Association of Familial Hypertension and Risk of Gestational Hypertension and Preeclampsia

“…The discrepancies between the studies could be attributed to differences in clinical methodology, sizes of the studied groups, risk of the studied populations, the numbers of early-onset preeclampsia (PE) (<34th weeks) and late-onset PE cases, ethnic differences, as well as differences in the definitions of ‘family hypertension’ or ‘hypertension in pregnancy’ and the degree of adjustment [ 4 , 8 , 11 , 12 , 13 , 21 ].…”

“…This disease, which is characteristic of pregnancy, develops de novo after 20 weeks of gestation and includes gestational hypertension (GH) and preeclampsia (PE) as well as PE superimposed on chronic hypertension [ 2 ]. PIH affects an average of 10% of pregnant women, although in some regions of the world this percentage is much higher [ 1 , 3 , 4 ]. Preeclampsia (PE) (in which high blood pressure is accompanied by particular organ disorders) occurs on average in 2–5% of pregnancies [ 2 ] but is seven times more common in developing than in developed countries [ 5 ].…”

“…A family history of hypertension is also considered [ 2 , 7 ]. Family history of hypertension (which is already available before pregnancy) may predispose pregnant women to develop PIH, providing information about the potential influence of genetic and environmental factors [ 2 , 4 , 7 , 8 , 9 , 10 ].…”

“…However, the role of the family history of hypertension as an independent risk factor of pregnancy-induced hypertension (PIH) has not been clearly established [ 4 , 8 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Only the Society of Obstetricians and Gynaecologists of Canada (SOGC) 2014 guidelines list a family history of early cardiovascular disease among the risk factors for preeclampsia (PE) that determine the use of aspirin prophylaxis, in contrast to the guidelines of other scientific societies [ 11 ].…”