Determinants of eclampsia in women with severe preeclampsia at Mpilo Central Hospital, Bulawayo, Zimbabwe.

Objective: Globally, preeclampsia is a significant contributor to adverse maternal outcomes. Once women develop eclampsia, they face considerable risks especially in countries with limited resources to deal with such a life-threatening complication. This study was carried out to investigate determinants of eclampsia in pregnant mothers with severe preeclampsia.

Study Design: This institutional based study was completed at Mpilo Central Hospital, a quaternary referral unit from 1st January 2016 - 31st December 2018. In this study, pregnant women with severe preeclampsia/eclampsia were the study participants. The independent variables included socio-demographic and clinical characteristics, and maternal outcomes. Multivariable logistic regression analyses were used to determine independent association with p < 0.05 taken as statistically significant with 95% Confidence Interval (CI).

Main Outcome Measure: Eclampsia.

Results: Development of eclampsia was more frequent in women aged 14-19 years compared to women aged ≥ 35 years (adjusted odds ratio (AOR) 6.64, 95% CI 1.20-22.06, p = 0.02) and in primiparous women compared to women with parity ≥ 3 (AOR 2.76, 95% CI 1.48-5.15, p = 0.001). Eclampsia was more frequent in women with diastolic blood pressure of 131-150 mmHg (AOR 5.48, 95% CI 1.05-28.75, p = 0.04), and ≥ 150 mmHg (AOR 5.78, 95% CI 1.05-31.78, p = 0.04) compared with those with diastolic blood pressure of ≤ 110 mmHg. Symptoms of visual disturbances were also associated with eclampsia (AOR 2.13, 95% CI 1.08-4.18, p = 0.03).

Conclusions: This study has identified independent determinants of eclampsia which can be used to identify which women should receive magnesium sulphate prophlyaxis or more intensive monitoring to prevent deterioration in maternal condition.