Mat Tamizi, Nurdiyana Farhana
(2017)
The severity of preeclampsia and its associated factors in Hospital Universiti Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: Preeclampsia (PE) is one of the leading cause of maternal mortality and
morbidity worldwide. It occurs after 20 weeks of gestation with the presence of
hypertension and proteinuria. The aim of this study was to determine the proportion and
the associated factors of PE according to its severity among patients in Hospital USM.
Methods: A cross-sectional study involving 200 patients diagnosed with PE between years
of 2011 to 2016 who were followed up and delivered in Hospital USM were included in
this study. Patients from other referral hospitals in Kelantan and nearer states were also
included to be the study samples. We also include those of chronic hypertension with
superimposed PE, hemolysis, elevated liver enzymes, and low platelet count (HELLP)
syndrome, and eclampsia. The severity classification of mild, moderate and severe PE was
determined based on the National Institute of Health and Care Excellence (NICE)
guideline. Ordinal logistic regression was used for analyzing. Results: The percentage of
PE among patients in Hospital USM were found to be 34.7% in mild, 30.2% in moderate
and 35.1% in severe cases. Higher uric acid resulted in greater odds of getting severe versus
mild PE (Adjusted odds ratio (OR): 1.05, 95% CI: 1.02, 1.07) after adjusted for other
variables. Patients having chronic hypertension (Adjusted OR: 2.36, 95% CI: 1.28, 4.33)
and gestational diabetes mellitus (GDM) (Adjusted OR: 0.53, 95% CI: 0.30, 0.96) were
also found to be associated with the severity of PE. Conclusion: Those who developedmild and severe PE was higher compared to moderate PE in this population. Patients with
high uric acid and chronic hypertension have higher chances to get severe PE, while those
with GDM was more likely to have mild PE. Uric acid, chronic hypertension, and GDM
were significantly found to be associated with the severity of PE among patients in Hospital
USM. A routine screening for PE based on BP and urine protein measurement should be
practiced and done at every antenatal visit as recommended by World Health Organization
(WHO).
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