An Assessment of risk factors associated with Preeclampsia among Antenatal Clients at Ndola Teaching Hospital

Abstract

Pre-eclampsia is a major hypertensive disorder in pregnancy and among the leading cause of maternal morbidity and mortality in sub-Sahara Africa. However, evidence on the burden and associated risk factors especially in tertiary level hospitals in Zambia remains limited. Therefore, this study aimed to determine the risk factors associated with preeclampsia among antenatal clients at Ndola Teaching Hospital for the period January 2023 to December 2024. This was a cross-sectional study that was conducted at Ndola Teaching Hospital (NTH) by utilizing 440 maternity records from January, 2023 to December 2024. Data on social demographic characteristics, obstetric history, and clinical factors were extracted using a data extraction tool. Descriptive statistics were used to summarize participants characteristics and estimate the prevalence of pre-eclampsia. Bivariate analyses and multivariate logistics regression analysis to identify factors associated with pre-eclampsia. Model fit was assessed using Hosmer-Lemeshow goodness of fit test and variance inflation factor (VIF) analysis was conducted to determine multicollinearity. Statistical significance was set at p < 0.05. The prevalence of pre-eclampsia was 14.1% among the reviewed records. Factors associated with pre-eclampsia included maternal age less than 20 (AOR 2.7, CI 1.02 - 3.87, p = 0.04), maternal age more than 35 (AOR 2.9, CI 1.05 - 4.74, p = 0.03), previous history of preeclampsia (AOR 3.2, CI 1.57 - 6.56, p < 0.001), multiple pregnancy (AOR 2.4, CI 1.03 - 5.74, p value = 0.04), obesity (AOR 2.87, CI 1.48 - 5.56, p value < 0.001), chronic hypertension (AOR 4.1, CI 2.02 - 8.23, p value <0.001), and history of diabetes mellitus (AOR 2.6, CI 1.06 - 6.45, p value = 0.03). Socio-demographic factors such as education, residence, and HIV status were not associated with pre-eclampsia. Pre-eclampsia remains a burden at Ndola Teaching Hospital with a relatively high prevalence with identifiable maternal and clinical risk factors. Pre-eclampsia, obstetric factors, maternal factors, clinical factors, antenatal care