Incidence of preeclampsia and retention to prenatal care in Northern Uganda

Abstract

Background: Known risk factors for preeclampsia include women of African descent and low socioeconomic status. This means all the mothers in Northern Uganda are at risk. In Uganda preeclampsia causes 12 – 19% of maternal deaths. However, data on its burden is limited.

Objective: To determine prenatal care retention and preeclampsia incidence in northern Uganda.

Setting: St. Mary’s hospital Lacor, northern Uganda.

Design: Prospective cohort study.

Participants: Recruited 1,285 mothers at 16-24 weeks of gestation. Their history, physical findings, blood tests, and uterine artery Doppler indices were taken at baseline, and the women were followed up until delivery.

Outcome: A combination of hypertension with proteinuria was taken as preeclampsia.

Statistical analysis: Means, medians, and proportions were used to describe the population. The incidence per 104 women weeks of follow-up computed for different gestation ages.

Results: Seventy-eight percent of the women delivered at the health facility. Women who were not retained through to delivery were younger (p<0.0001), had low BMI (p=0.0001) and more likely to be unemployed (p<0.0001). Overall, 43 women developed preeclampsia giving a prevalence of 4.3% (95% CI 3.1% - 5.7%), and an incidence of 11 per 104 women weeks. The incidence of preeclampsia was 68 per 104 women weeks’ for women delivered at < 34 completed weeks of pregnancy, and 6.0 per 104 women weeks for those delivered at > 37 weeks.

Conclusion: Retention to prenatal care is 78% while the incidence of preeclampsia is 4.3% in Northern Uganda. This incidence is higher at lower gestation ages.