Predictors and pathways associated with potentially high-risk preeclampsia among pregnant women in selected health facilities in Accra, Ghana

Abstract

Preeclampsia (PE) is one of the major complications associated with pregnancy. The study sought to determine the predictors associated with potentially high risk for PE and their pathways. This was a prospective study conducted among 403 pregnant women, ≤ 20 weeks of gestational age, who attended antenatal clinic at two hospitals in Accra and were followed till 6 weeks postpartum. The Body Mass Index was calculated based on the World Health Organization criteria. Potentially high risk for preeclampsia was defined as having at least one of the following: systolic blood pressure ≥ 130 mmHg, diastolic blood pressure ≥ 80 mmHg, oedema, and proteinuria. Data analyses were carried out using SPSS Version 22. Binary logistic regression and structural equation modeling were performed to determine the predictors and their pathways respectively. Majority 341 (84.6) of the respondents were aged 20-35 years. Pregnant women with estimated pre-pregnancy BMI ≥ 30 kg/m2 and pre-pregnancy weight ≥71 kg were at significantly increased risk of being at a potentially high risk for PE AOR 3.6; 95%CI (1.09 – 11.75) p < 0.040 and AOR 3.4; 95% CI (1.250 - 12.703) p < 0.019 respectively. Anthropometric indices (estimated pre-pregnancy BMI and pre-pregnancy weight) had a statistically significant positive direct relationship with potentially high risk for PE; β = 0.519; t-value = 8.545; p-value < 0.001). Estimated pre-pregnancy weight and BMI (obesity ≥ 30 kg/m²) were the predictors and also had a significant direct positive relationship with potentially high risk for PE.