Influence of Antenatal Factors on Maternal and Neonatal Outcomes among Pregnant Women with Pre-Eclampsia and Eclampsia admitted at Kakamega County Referral Hospital, Kenya.

Abstract

Pre-eclampsia and eclampsia are pregnancy related complications affecting majority of women globally. This problem is more prevalent   in low- and middle-income countries compared to the developed countries and account for 16% of maternal and neonatal morbidity and mortality. There is paucity of literature linking antenatal factors and interventions with maternal and neonatal outcomes among pre-eclamptic and eclamptic women.  The aim of the study was to determine the effect of antenatal factors on maternal and neonatal outcomes of pregnant mothers with pre-eclampsia and eclampsia admitted at Kakamega County   Teaching and Referral Hospital (KCTRH). The study utilised cross-sectional analytical design.  Purposive sampling was used to select 239 respondents who met inclusion criteria. Structured questionnaire was used to collect data from the participants as well as recorded data from files of the participants.   Data collected was analysed using Statistical Package for the Social Sciences (SPSS) software version21. Frequencies, proportions, logistic regression and Odds Ratio (OR) were used to present and analyse the data. High blood pressure during antenatal period among mothers had a significant impact with more adverse maternal outcome compared with their counterparts (OR: 2.5; 95% CI: 1.2 – 5.2; p = 0.009). Mothers who met the minimum required ANC visits were 90% less likely to have had adverse neonatal outcome (OR: 0.1; 95% CI: 0.01 – 0.49; p = 0.0005) compared to those who had few number of visits. Likewise, mothers with no previous history of abortion were 80% less likely to have had adverse neonatal outcome (OR: 0.2; 95% CI: 0.04 – 0.90; p = 0.02). Although not statistically significant, the relationship between presence of fetal heart rate during antenatal period and adverse neonatal outcome was marginally significant (OR: 1.8; 95% CI: 0.9 – 3.3; p = 0.07). Cases where fetal heart rate was not heard were almost twice as likely to have presented with adverse neonatal outcome. Conclusion:  Regular antenatal visits among these mothers was linked to better health outcomes but persistent hypertension led to more adverse outcomes. Recommendations: Health care workers to increase awareness and education on the importance of regular antenatal care visits among mothers with pre-eclampsia and intensify monitoring and follow-up scheduled programs for these women to reduce adverse maternal and neonatal outcomes.