Risk factors for the development of new-onset and persistent postpartum preeclampsia: A case–control study in Ghana

Abstract

Background: Postpartum preeclampsia has been implicated in increasing hospital re-admissions, maternal morbidity, and mortality worldwide. The knowledge of the risk factors of postpartum preeclampsia would be helpful in formulating strategies to aid in the prevention, early diagnosis, and timely treatment of this disorder. Thus, this study aimed to identify the risk factors associated with the development of new-onset postpartum preeclampsia and persistent postpartum preeclampsia in the Ghanaian setting. Methods: This case–control study was conducted at the Obstetrics and Gynecology units of Komfo Anokye Teaching Hospital and the Kumasi Regional Hospital, both located in the Ashanti Region of Ghana. A total of 65 postpartum preeclamptic women (33 new-onset postpartum preeclampsia and 32 persistent postpartum preeclampsia) and 65 normotensive postpartum mothers were recruited from 48 h to 6 weeks post-delivery. Questionnaires were administered to assess the socio-demographic, lifestyle, obstetric characteristics, and past medical history of the study participants. Results: Physical inactivity ( p < 0.0001), infrequent antenatal visits ( p < 0.0001), analgesic use ( p < 0.0001), and cesarean delivery ( p = 0.021) were significantly associated with both the new-onset postpartum preeclampsia and persistent postpartum preeclampsia. Contraceptive use was significantly associated with the development of new-onset postpartum preeclampsia ( p < 0.0001) while women with low-birthweight babies are also at high risk of developing persistent postpartum preeclampsia ( p < 0.0001). Conclusion: Physical inactivity, infrequent antenatal visits, analgesic use, contraceptive use, and cesarean delivery are major predisposing risk factors for the development of postpartum preeclampsia. Screening using these risk factors, close monitoring and follow-up observation of women after delivery would be beneficial in identifying and managing postpartum preeclampsia.

Preeclampsia in Ghana: A study on the prevalence and risk factors of postpartum readmission in the Ashanti Region

“…The association between family history of hypertension and the incidence of preeclampsia has been reported by previous studies [26–28]. Preeclampsia persists after delivery discharge in women with a family history of hypertension [29]. Our findings agree with this previous study and go further to show that such patients are likely to be readmitted.…”

“…One study reported no significant association between parity groups and readmission [21]. Another study showed no association between the persistence of preeclampsia after delivery and parity groups [29]. These conflicting reports may be due to the small sample size of this study or external factors such as the quality of prenatal care received and dietary and lifestyle practices, which were not assessed in this study.…”

Adipsin as a marker of preeclampsia in a Ghanaian community

“…Our study also revealed that poor previous obstetric outcome like cesarean section (CS) had relationship with PE in consonance with a previous study which stated that regardless of parity or gestational age, cesarean deliveries were more common in preeclamptic women who had labor induction than in non-preeclamptics [25], [26]. Compared to the normotensives, those with family history of hypertension had higher risk of developing PE in line with a similar study done in Kumasi, Ghana [25]. Our study did not nd signi cant relationship between parity, gravidity, stillbirth, miscarriages and PE though many studies have linked these factors to the onset of PE.…”

Maternal Health Considerations: Highlighting and advancing opportunities for improved maternal health

“…Physical inactivity and other risk factors were investigated by Fondjo et al 29 in the pursuit of understanding postpartum preeclampsia. Postpartum preeclampsia poses significant risks globally, including hospital readmissions and maternal complications.…”