Maternal physical and social characteristics that influence the occurrence of preeclampsia/eclampsia and hemorrhage in Eastern Region of Ghana. A prospective cohort study

Abstract

Background: Preeclampsia/eclampsia places grave barriers to the successful reduction of maternal mortality and morbidity. These barriers have significant adverse outcomes for most women especially in sub-Saharan Africa, with Ghana contributing 88.7% of preeclampsia cases in Africa. Aim: The aim of this study is to evaluate the maternal, physical and social characteristics that influence the occurrence of preeclampsia/eclampsia in Eastern Region of Ghana. Methods: A prospective cohort study was conducted among pregnant women with gestational age > 28 weeks seeking antenatal care in seven hospitals in the Eastern Region of Ghana from October 2022 to March 2023. Using a simple random sampling technique, 445 patients were recruited at the antenatal care clinics using the antenatal care register as the reference point, and their delivery outcomes were evaluated after 13 weeks of follow-up. Results: The study shows that pregnant women with poor personal hygiene are 10 times the odds (aOR: 10.169, p < 0.001, 95% CI: 4.896–21.121) of developing preeclampsia/eclampsia compared to those with good personal hygiene and about five times the risk of haemorrhage (RRR: 5.12, p -value = 0.014, 95% CI: 1.393–18.815) compared to those who are normal. Those who opted for Jadelle contraceptives had 3.4 times the odds (aOR: 3.419, p = 0.028, 95% CI: 1.143–10.227) of developing preeclampsia/eclampsia compared to those who used Depo-Provera contraceptives. Women who depended on borehole as their source of drinking water were 6.95 times the odds (aOR: 6.951, p = 0.013, 95% CI: 1.511–31.981) of developing preeclampsia/eclampsia compared to those who used sachet water. Furthermore, there was statistically significant association between comorbidity conditions and haemorrhage. Conclusion: The study showed that pregnant women with poor personal hygiene were 10 times more likely to develop preeclampsia/eclampsia compared to those with good personal hygiene. The use of some family planning methods may influence the development of preeclampsia/eclampsia. Women need to seek medical advice on contraceptives before and during pregnancy before choosing contraceptives methods. Also, effective community-based health planning and services concept should be implemented to improve access to family planning services in the rural communities.