Maternal Risk Factors and Obstetric Characteristics Associated with Severe Preeclampsia in the Puerperal Period

Open Access

Abstract

Background: Severe preeclampsia is a multisystem hypertensive disorder associated with serious maternal and obstetric complications. Persistent abnormalities after delivery make the puerperal period an important phase of maternal care. Aim of the study: To assess maternal risk factors and obstetric characteristics associated with severe preeclampsia in the puerperal period. Methods & Materials: This prospective observational study included 50 women with severe preeclampsia who were enrolled consecutively at a tertiary care center in Bangladesh. Maternal sociodemographic characteristics, medical risk factors, obstetric history, pregnancy-related clinical features, maternal complications, delivery outcomes, and postpartum clinical status were assessed. Postpartum evaluation included blood pressure, antihypertensive treatment, renal function, proteinuria, and readmission. Factors associated with severe preeclampsia were evaluated using multivariable logistic regression. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated, and p<0.05 was considered statistically significant. Result: The mean maternal age was 24.1±3.5 years, and 70.0% were aged 18-24 years. Family history of hypertension/preeclampsia (24.0%), BMI >30 kg/m² (22.0%), and chronic hypertension (18.0%) were the most frequent maternal risk factors. Early-onset severe preeclampsia occurred in 38.0%, while 54.0% delivered preterm and 62.0% underwent cesarean delivery. Severe headache (78.0%), epigastric/right upper quadrant pain (72.0%), and visual disturbance (62.0%) were common clinical features. Persistent hypertension at discharge occurred in 96.0%, and proteinuria remained positive in 72.0% at 12 weeks. Chronic hypertension, previous preeclampsia, family history, BMI >30 kg/m², early-onset disease, epigastric/right upper quadrant pain, thrombocytopenia, and acute renal failure were independently associated with severe disease (p<0.05). Conclusion: Severe preeclampsia was associated with substantial maternal morbidity, preterm delivery, and persistent postpartum hypertension. Identification of high-risk characteristics and continued postpartum surveillance are important for maternal care.