A 5 year review of pre-eclampsia in Hospital Universiti Sains Malaysia

Hanafi, Nor Fatimah Zakiah (2022) A 5 year review of pre-eclampsia in Hospital Universiti Sains Malaysia. Masters thesis, Universiti Sains Malaysia.

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Abstract

Objective: To determine the rate of early onset pre-eclampsia (onset of pre-eclampsia before 34 weeks) and late onset pre-eclampsia (onset of pre-eclampsia after 34 weeks) in patients who delivered in Hospital Universiti Sains Malaysia, the risk factors, the maternal and fetal outcomes for both groups and the associated factor for poor maternal and neonatal outcomes of both groups. Methodology: This retrospective observational study involved all patients with singleton deliveries in Hospital Universiti Sains Malaysia, with the diagnosis of pre-eclampsia from January 2016 until December 2020. The demographic data, co-morbid, clinical presentation, clinical assessment, laboratory results, mode of delivery, and outcome were retrieved from the case notes and recorded and analyzed. Categorical data were analyzed by n (percent) and numerical data were analyzed by mean (SD) and median (IQR). Simple logistic regression testing was used to test for factors associated with poor maternal and fetal outcomes in pre-eclampsia. Any significant variables with a p-value <0.25 were included in multiple logistic regression for further analysis, and variables with p-value <0.05 were considered significant. Results: 108 (30.8%) of 351 cases had early onset pre-eclampsia, 243 (69.2%) had late onset pre-eclampsia. The prevalence rate of pre-eclampsia in our centre was 1.4%. Advanced maternal age occurs in 43.5% of the early onset pre-eclampsia group vs 24.3% in the late onset group. 58.3% of women in the early onset group had a history of pre-eclampsia in a previous pregnancy, and they were likely to be obese (59.3% vs 46.1%). Chronic hypertension significantly increased the risk for early onset pre-eclampsia. Nulliparous women were more likely to develop late onset pre-eclampsia although not statistically significant. Women with early onset pre-eclampsia had a higher percentage of the poor maternal outcome (33% vs 21%). In addition, their babies had significantly increased rates of morbidity and mortality. Among women with early onset pre-eclampsia that had a maternal complication, they were more likely to have a history of pre-eclampsia and obese, although not statistically significant. Furthermore, among women with late onset pre-eclampsia that had a maternal complication, they were likely to be nulliparous or had a shorter interpregnancy interval of less than 2 years, although not statistically significant. Among women with early onset pre-eclampsia that had poor perinatal outcomes, there was a higher percentage of advanced maternal age and nulliparous women, and among women with late onset pre-eclampsia that had poor perinatal outcomes, there was a higher percentage of patients with Diabetes Mellitus and obese. However, these differences failed to reach statistical significance. Conclusion: The prevalence of pre-eclampsia in the general population was 1.4% which was comparable to other Asian countries. Some risk factors were common to both early and late onset pre-eclampsia, however, several risk factors had quantitatively different associations with the 2 subtypes of pre-eclampsia. Pre-eclampsia causes significant maternal complications, especially early onset pre-eclampsia. Outcomes of babies of women with early onset pre-eclampsia are significantly worse than for those who presented later. Overall, women presenting with pre-eclampsia after 34 weeks have generally good maternal and fetal outcome.

Item Type:	Thesis (Masters)
Uncontrolled Keywords:	pre-eclampsia
Subjects:	R Medicine R Medicine > RG Gynecology and obstetrics
Divisions:	Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Thesis
Depositing User:	MUHAMMAD AKIF AIMAN AB SHUKOR
Date Deposited:	09 Jun 2026 03:21
Last Modified:	30 Aug 2026 06:49
URI:	http://eprints.usm.my/id/eprint/64328

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