Comparison of outcomes in early and late onset preeclampsia in two district hospitals in Abuja

Abstract

Introduction: Preeclampsia is a leading cause of maternal and perinatal morbidity and mortality. Early and late onset preeclampsia represents two distinct phenotypes having specific pathophysiology and differing clinical outcomes. Early onset preeclampsia (EOPE) is known for its life threatening manifestations. Late onset preeclampsia (LOPE) is more prevalent in developing countries and evolving research has revealed its association with worse outcomes. This study aimed at comparing outcomes in EOPE and LOPE in two district hospitals in Abuja.

Methodology: A prospective cohort study involving 120 women diagnosed with preeclampsia using the revised International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria. Participants were stratified into EOPE and LOPE depending on gestational age at diagnosis. Maternal and perinatal outcomes were noted throughout pregnancy, delivery and at the immediate post-partum period.

Result: Maternal outcomes such as progression to severe hypertension, eclampsia, abruptio placentae, acute kidney injury and mode of delivery were comparable in EOPE and LOPE (P>0.05). There was a statistically significant risk for stillbirth, low APGAR score, neonatal admission, preterm complications and overall perinatal mortality in EOPE while the risk for small for gestational age infant was higher in LOPE (P<0.05). The case fatality rate was 1.7%.

Conclusion: Preeclampsia, irrespective of its time of onset, portends adverse maternal and perinatal complications. Its diagnosis at any time should prompt heightened surveillance and timely institution of management to optimize outcomes.

Keywords: Outcomes, early onset, late onset, preeclampsia, ISSHP