Knowledge of preeclampsia and its associated factors among pregnant women.: a possible link to reduce related adverse outcomes

Abstract

Background: Pre-eclampsia (PE) is one of the leading causes of maternal morbidity and mortality globally. Adequate knowledge about a disorder contributes greatly to its prevention, control and management. This study assessed the level of knowledge of PE and evaluated the factors associated with knowledge adequacy among pregnant women attending antenatal care at a University Hospital in Kumasi-Ghana. Methods: This cross-sectional study was conducted at the at a University Hospital in Kumasi, Ghana. A closed-ended validated well-structured questionnaire was used to collect socio-demographic information and history of PE. Knowledge of PE was assessed based on a series of questions regarding the awareness, signs/symptoms, risk factors and complications of PE. Responses were scored percentage-wise and grouped into low (<60%), moderate (60-80%) and high (80-100%). Knowledge score was then re-stratified into adequate (% score of ≥ 60%) and inadequate knowledge of PE (% score of < 60%). Results: The prevalence of inadequate and adequate knowledge of PE was 88.6% (mean score = 55.5 ± 4.3%) and 11.4% (mean score = 76.3 ± 5.9%), respectively. For participants with adequate knowledge of PE, 9.1% (mean score = 67.4 ± 6.9%) and 2.3% (mean score = 85.2 ± 5.1%) had moderate and high knowledge, respectively. Using univariate logistic regression models, being older (>35 years old) [cOR=3.09, 95%CI (0.88-10.88), p=0.049] and having a higher level of education (> SHS education) [cOR=4.45, 95%CI (2.18-9.10), p<0.0001] were significantly associated with greater odds of having adequate knowledge of PE. After controlling for potential confounders in multivariate logistic regression analysis, we found higher level of education to be independently associated with adequate knowledge of PE [aOR=2.87, 95%CI (1.31-6.30), p=0.008]. Conclusion: The knowledge of PE among pregnant women in Ghana is low. The prominent factor that facilitates adequacy of knowledge of PE is higher level of education.

Preeclampsia knowledge among postpartum women treated for preeclampsia and eclampsia at Korle Bu Teaching Hospital in Accra, Ghana

“…Consistent with findings from studies of pregnant women in the United States [ 16 ], elsewhere in Ghana [ 17 ], and in other LMICs [ 21 – 23 ], our study demonstrates a low level of knowledge about preeclampsia/eclampsia. In the United States, 57% of participants reported being counseled on signs and symptoms of preeclampsia/eclampsia [ 16 ], compared to only 49% in our Ghanaian population.…”

“…Our multivariate analysis demonstrated that after controlling for age, parity, and number of antenatal visits, a higher knowledge score was predicted by a higher level of education and an increased amount of direct provider counseling. Consistent with findings from studies of pregnant women in the United States [16], elsewhere in Ghana [17], and in other LMICs [21][22][23], our study demonstrates a low level of knowledge about preeclampsia/ eclampsia. In the United States, 57% of participants reported being counseled on signs and symptoms of preeclampsia/eclampsia [16], compared to only 49% in our Ghanaian population.…”

“…This key relationship has not been extensively explored, but agrees with findings from the United States [16,18]. Education level was also a significant predictor of knowledge score, which is concordant with other studies performed in Ghana [17] and the United States [18]. Other studies demonstrated that higher literacy, multiparity, and a history of preeclampsia in a prior pregnancy were predictive of knowledge scores [18].…”

“…Despite the important connections between women's knowledge of warning signs and seeking appropriate care, little research has addressed the patient perspective. Studies conducted in high-income countries demonstrate that only half of patients were counseled on signs and symptoms of preeclampsia [16], even though counseling by healthcare providers is associated with increased patient knowledge [16][17][18].…”

“…In LMICs, healthcare providers and patients face unique challenges, including lower general education levels and health literacy, and limited access and utilization of antenatal care services [19,20]. Previous research in Ghana [17], Tanzania [21,22], and Malaysia [23] all demonstrate low levels of knowledge about preeclampsia among pregnant women. However, none of these studies focused on women with a clinical diagnosis of preeclampsia or eclampsia.…”