Godana Abduro, Dessalegn Dula, Adem Fuad, Edessa Dumessa
Department of Clinical Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Department of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
Int J Womens Health. 2021 Aug 28;13:781-791. doi: 10.2147/IJWH.S321128. eCollection 2021.
Eclampsia contributes to 12% of all maternal deaths worldwide during pregnancy. Again, women with severe preeclampsia and eclampsia had a three to 25-fold increased risk of severe complications. Therefore, this study was aimed to determine treatment outcomes and determinants of eclampsia and severe preeclampsia among pregnant women admitted to selected tertiary hospitals.
A prospective cohort study was conducted on 217 women with eclampsia or severe preeclampsia from April 1 to October 30, 2019. Data were collected from patients' chart, questionnaire-based interviews at baseline and telephone interviews during follow-up. Then, the collected data were entered into EpiData 3.1 and exported to SPSS 21.0 for final analysis. Kaplan-Meier (log rank test) and Cox regression were employed to compare baseline survival experience and to adjust for the predictors of clinical outcomes, respectively.
Of 217 women, 80.2% of them developed maternal complications, while nine (4.2%) women died. Determinant factors of maternal complications were linked with eclampsia case (AHR: 1.98; 95%CI: 1.28-3.06; =0.002), lack of ANC follow-up (AHR: 1.75; 95%CI: 1.22-2.51; =0.002), presence of maternal leukocytosis (AHR: 1.53; 95%CI: 1.12-2.09; =0.008), elevated serum creatinine (AHR: 1.51; 95%CI: 1.05-2.17; =0.02), and maternal age of 20-35 years (AHR: 0.61; 95%CI: 0.41-0.90; =0.01).
Despite improved survival of women with preeclampsia/eclampsia, different complications that they experienced remained serious problems. We suggest strategies that comprise frequent ANC follow-up and check-up for women with leukocytosis and kidney impairment so as to optimally prevent and treat eclampsia and preeclampsia during pregnancy.
子痫导致全球孕期孕产妇死亡总数的12%。此外，重度子痫前期和子痫患者出现严重并发症的风险增加了3至25倍。因此，本研究旨在确定入住选定三级医院的孕妇中，子痫和重度子痫前期的治疗结果及决定因素。
2019年4月1日至10月30日，对217例子痫或重度子痫前期患者进行了一项前瞻性队列研究。数据收集自患者病历、基线时基于问卷的访谈以及随访期间的电话访谈。然后，将收集到的数据录入EpiData 3.1，并导出到SPSS 21.0进行最终分析。分别采用Kaplan-Meier（对数秩检验）和Cox回归比较基线生存经验并调整临床结局的预测因素。
217例患者中，80.2%出现了孕产妇并发症，9例（4.2%）患者死亡。孕产妇并发症的决定因素与子痫病例相关（调整后风险比：1.98；95%置信区间：1.28 - 3.06；P = 0.002）、缺乏产前检查随访（调整后风险比：1.75；95%置信区间：1.22 - 2.51；P = 0.002）、存在孕产妇白细胞增多（调整后风险比：1.53；95%置信区间：1.12 - 2.09；P = 0.008）、血清肌酐升高（调整后风险比：1.51；95%置信区间：1.05 - 2.17；P = 0.02）以及孕产妇年龄在20至35岁之间（调整后风险比：0.61；95%置信区间：0.41 - 0.90；P = 0.01）。
尽管子痫前期/子痫患者的生存率有所提高，但她们所经历的各种并发症仍然是严重问题。我们建议采取包括对白细胞增多和肾功能损害的女性进行频繁的产前检查随访和检查等策略，以便在孕期最佳地预防和治疗子痫和子痫前期。
