Predictive Value of Maternal Risk Factors, Mean Arterial Blood Pressure and Haematocrit for Preeclampsia at the University of Benin Teaching Hospital, Nigeria

Abstract

ABSTRACT

Background: Preeclampsia (PE) presents a significant global health challenge, particularly impacting materno-foetal health in developing nations. It manifests as hypertension and significant proteinuria or evidence of organ dysfunction after 20 weeks gestation; in previously normotensive non-proteinuric women. This study aimed at assessing the value of combining maternal risk factors, mean arterial blood pressure and haematocrit in the predicting PE.

Methods: This was a prospective cohort study done at the University of Benin Teaching Hospital. Two-hundred and six pregnant women were recruited at <16 weeks gestation and followed up till delivery. Maternal risk factors, mean arterial blood pressure (MAP) and haematocrit were assessed. Primary outcome was development of pre-eclampsia. Data was analysed using SPSS version 25. The predictability of the parameters was established by determining their sensitivity, specificity and receiver operating characteristic curve.

Results: Incidence of pre-eclampsia was 22.1%. Independent predictors of pre-eclampsia were family history of hypertension and previous preeclampsia. A significant MAP of 87.4mmHg ± 9.7SD was found for the pre-eclamptics compared to 79.4mmHg ± 7.8SD in the normotensives. Significant mean haematocrits of 35.7% ± 3.6SD and 32.4% ± 2.6SD were also noted for pre-eclamptics and normotensives, respectively. Maternal risk factors, MAP and haematocrit had a sensitivity of 35.5%, 33.3% and 35.6%, respectively. Combining the three parameters was predictive of Pre-eclampsia at 55% sensitivity.

Conclusion: A high incidence of 22.1% buttresses the need for close surveillance. A combination of maternal risk factors, MAP and haematocrit may be helpful in screening and predicting pre-eclampsia as early as first trimester.