Maternal and Health System Predictors of Preeclampsia among Pregnant Women Attending Health Care Facilities in Lusaka, Zambia: A Retrospective Cohort Study

Abstract

Preeclampsia (PE) is the leading cause of maternal and perinatal morbidity/mortality. A study in Lusaka estimated Preeclampsia/Eclampsia prevalence at 18.9%. The aim of the study was to determine the health system and maternal predictors of preeclampsia among pregnant women attending public health facilities (HF) in Lusaka, Zambia. This is a 12months retrospective cohort study. Records of 770 pregnant women during antenatal care between January to December 2020 from five HFs in Lusaka were reviewed and classified into with or without PE. The risk factors for PE were abstracted from the records. Descriptive analysis and inferential statistics were determined. The respondents were aged 18-40years with mean age of 27.09 years and SD±5.1. Age 25-32 years accounted for 344 (45%), Married 250 (82%), 346 (45%) had secondary school education and 293 (38%) had parity of 2. Significant differences were observed in the administration of magnesium sulphate and oxygen for severe preeclampsia (p = 0.001) and anti-hypertensive for eclampsia (p < 0.05). Knowledge gaps in the diagnosis and management of pre-eclampsia were identified. Multivariate analysis revealed woman’s age (aOR= 0.326, 95% CI: 0.0024-0.8231), education aOR= 0.128, 95% CI: 0.00121-0.0323) and a good nutritional diet aOR= 0.109, 95% CI: 0.0393-0.4639) were independent predator of PE. Predictors of PE amongst pregnant women were having preeclampsia in the previous pregnancy, having parity of three or more, and knowledge gaps in the diagnosis and management of PE were found. We recommend refresher training on detection and management of PE among health workers attending to pregnant women.