Determinants of new-onset postpartum preeclampsia among mothers who delivered in hospitals in the South Gondar Zone, Northwest Ethiopia: a multicenter case-control study.

Dagne Addisu, Yekaba Mitiku, Wassie Yazie Ferede, Begizew Yimenu Mekuriaw, Besfat Berihun Erega, Lakachew Yismaw Bazezew, Tegegne Wale Belachew, Selamawit Girma Tadesse, Yitayal Ayalew Goshu, Belaynew Alemye Mengistie, Maru Mekie, Agernesh Dereje Misker, Gedefaye Nibret Mihretie
Author Information
  1. Dagne Addisu: Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia. addisudagne7@gmail.com.
  2. Yekaba Mitiku: Department of Midwifery, Debre Tabor Comprehensive Specialized Hospital, Debre Tabor, Ethiopia.
  3. Wassie Yazie Ferede: Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia.
  4. Begizew Yimenu Mekuriaw: Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia.
  5. Besfat Berihun Erega: Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia.
  6. Lakachew Yismaw Bazezew: Department of Pediatrics and Neonatal Nursing, Debre Tabor University, Debre Tabor, Ethiopia.
  7. Tegegne Wale Belachew: Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia.
  8. Selamawit Girma Tadesse: Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia.
  9. Yitayal Ayalew Goshu: Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia.
  10. Belaynew Alemye Mengistie: Department of Midwifery, Debre Tabor Comprehensive Specialized Hospital, Debre Tabor, Ethiopia.
  11. Maru Mekie: Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia.
  12. Agernesh Dereje Misker: Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia.
  13. Gedefaye Nibret Mihretie: Department of Midwifery, Debre Tabor University, Debre Tabor, Ethiopia.

Abstract

BACKGROUND: New-onset postpartum preeclampsia has emerging as a significant public health concern in Ethiopia, with a notable increase in incidence in the study area. While substantial research exists on antepartum preeclampsia, data on the determinants of new-onset postpartum preeclampsia are limited. Therefore, this study aimed to investigate determinants of new-onset postpartum preeclampsia among mothers who gave birth at hospitals in the South Gondar Zone, Northwest Ethiopia.
METHODS: An unmatched case-control study was conducted with 355 postpartum mothers (89 cases and 266 controls). A multistage sampling method was used to select the study participants. Data were collected using structured questionnaires and medical chart reviews, and analyzed using SPSS Version 27. Binary logistic regression (bivariable and multivariable analysis) was used to identify factors associated with new-onset postpartum preeclampsia. Statistical significance was set at p < 0.05, and strength of associations were measured using adjusted odds ratios (AOR) with 95% confidence intervals (CIs).
RESULT: New-onset postpartum preeclampsia was significantly associated with several factors, including advanced maternal age, fewer antenatal care (ANC) visits, contraceptive use, physical inactivity, a history of multiple gestations, and gestational diabetes mellitus. Specifically, maternal age ≥ 40 years (AOR = 11.63, 95% CI: 4.24-31.86), fewer than four ANC visits (AOR = 8.45, 95% CI: 3.96-18.05), contraceptive use (AOR = 4.04, 95% CI: 1.26-13.37), irregular physical activity (AOR = 4.05, 95% CI: 1.32-12.44), physical inactivity (AOR = 8.25, 95% CI: 4.62-19.29), a history of multiple gestations (AOR = 2.66, 95% CI: 1.26-5.60), and gestational diabetes mellitus (AOR = 17.79, 95% CI: 7.72-40.95) were identified as key determinants.
CONCLUSIONS: Advanced maternal age, fewer ANC visits, contraceptive use, physical inactivity, multiple gestations, and gestational diabetes were strongly associated with new-onset postpartum preeclampsia. Increased ANC visits and postpartum monitoring are essential for early detection and management of postpartum preeclampsia. Additionally, promoting physical activity should be incorporated into maternal health strategies to reduce the incidence of new onset postpartum preeclampsia.

Keywords

References

  1. Front Endocrinol (Lausanne). 2020 Sep 11;11:655 [PMID: 33042016]
  2. Am J Obstet Gynecol. 2014 Apr;210(4):338.e1-338.e8 [PMID: 24211478]
  3. J Emerg Med. 2010 Feb;38(2):168-70 [PMID: 18547773]
  4. Hypertension. 2023 May;80(5):1067-1076 [PMID: 36883459]
  5. Curr Hypertens Rep. 2021 May 13;23(5):29 [PMID: 33982185]
  6. BJOG. 2024 Dec 2;: [PMID: 39623781]
  7. Am J Obstet Gynecol. 2022 Feb;226(2S):S963-S972 [PMID: 33712272]
  8. Best Pract Res Clin Obstet Gynaecol. 2024 Jun;94:102473 [PMID: 38513504]
  9. Nat Commun. 2020 Nov 25;11(1):5976 [PMID: 33239696]
  10. Curr Diab Rep. 2009 Aug;9(4):296-302 [PMID: 19640343]
  11. BMC Pregnancy Childbirth. 2016 Jun 02;16(1):131 [PMID: 27256279]
  12. N Engl J Med. 2002 Jan 3;346(1):33-8 [PMID: 11778000]
  13. Mediators Inflamm. 2015;2015:379501 [PMID: 25861161]
  14. PLoS One. 2023 Nov 14;18(11):e0287038 [PMID: 37963147]
  15. Obstet Gynecol. 2011 Nov;118(5):1102-1107 [PMID: 21979459]
  16. Vascul Pharmacol. 2023 Oct;152:107209 [PMID: 37591444]
  17. Ann N Y Acad Sci. 2013 Apr;1281:141-59 [PMID: 23167451]
  18. Arterioscler Thromb Vasc Biol. 2005 Apr;25(4):809-14 [PMID: 15692095]
  19. J Matern Fetal Neonatal Med. 2022 Dec;35(25):7179-7187 [PMID: 34374309]
  20. J Leukoc Biol. 2005 Oct;78(4):819-35 [PMID: 16033812]
  21. Hypertension. 2020 Jul;76(1):167-175 [PMID: 32475315]
  22. Pregnancy Hypertens. 2022 Aug;29:64-71 [PMID: 35797744]
  23. Br J Nutr. 2024 Jan 14;131(1):54-62 [PMID: 37519248]
  24. Curr Hypertens Rep. 2020 Nov 18;23(1):1 [PMID: 33210199]
  25. Sci Rep. 2019 Jul 15;9(1):10182 [PMID: 31308416]
  26. Best Pract Res Clin Obstet Gynaecol. 2015 Apr;29(3):328-38 [PMID: 25481558]
  27. Obstet Gynecol Sci. 2016 Nov;59(6):434-443 [PMID: 27896245]
  28. Womens Health (Lond). 2022 Jan-Dec;18:17455057221109362 [PMID: 35848351]
  29. Oxid Med Cell Longev. 2021 May 31;2021:5581570 [PMID: 34194606]
  30. Pflugers Arch. 2010 May;459(6):841-51 [PMID: 20213497]
  31. Can J Cardiol. 2018 Apr;34(4):485-491 [PMID: 29571429]
  32. Hypertens Res. 2023 Dec;46(12):2583-2592 [PMID: 37463981]
  33. J Reprod Med. 2012 Jan-Feb;57(1-2):35-8 [PMID: 22324265]
  34. Front Physiol. 2012 May 28;3:132 [PMID: 22783194]

MeSH Term

Humans
Female
Pre-Eclampsia
Ethiopia
Case-Control Studies
Pregnancy
Adult
Risk Factors
Prenatal Care
Young Adult
Postpartum Period
Diabetes, Gestational
Maternal Age
Mothers

Word Cloud

Created with Highcharts 10.0.0postpartumpreeclampsia95%CI:studynew-onsetphysicalmaternalANCvisitsEthiopiadeterminantsmothersSouthGondarZoneusingfactorsassociated05fewercontraceptiveuseinactivitymultiplegestationsgestationaldiabetes1New-onsethealthincidenceamonghospitalsNorthwestcase-controlusedagehistorymellitus4AOR = 8AOR = 4activitynewonsetDeterminantsBACKGROUND:emergingsignificantpublicconcernnotableincreaseareasubstantialresearchexistsantepartumdatalimitedThereforeaimedinvestigategavebirthMETHODS:unmatchedconducted35589cases266controlsmultistagesamplingmethodselectparticipantsDatacollectedstructuredquestionnairesmedicalchartreviewsanalyzedSPSSVersion27BinarylogisticregressionbivariablemultivariableanalysisidentifyStatisticalsignificancesetp < 0strengthassociationsmeasuredadjustedoddsratiosAORconfidenceintervalsCIsRESULT:significantlyseveralincludingadvancedantenatalcareSpecificallyage ≥ 40 yearsAOR = 116324-3186four45396-180426-1337irregular32-12442562-1929AOR = 26626-560AOR = 1779772-4095identifiedkeyCONCLUSIONS:AdvancedstronglyIncreasedmonitoringessentialearlydetectionmanagementAdditionallypromotingincorporatedstrategiesreducedeliveredEthiopia:multicenterMulticentercase–controlNew-OnsetRisk

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