Dissertation (MSc Midwifery)
Background: Severe preeclampsia disorder is more dominance in low and middle income countries. In Sub-Saharan Africa severe preeclampsia remains a major public health problem which contributes to 500/100,000 of maternal mortality. There is no published study conducted in Zanzibar on severe preeclampsia and fetal outcome This study, entitled to determine the risk factors of severe preeclampsia and its influences on fetal outcome among post-delivery women in Zanzibar.
Methods: A hospital based analytical cross sectional study design was used. A purposive sampling method was used for the selection of hospitals, while stratified sampling was used for the selection of representative from each hospital and participants were selected by using a systematic random sampling method. Study participants were post deliveries mothers with their neonates. The study had employed an interviewer administered questionnaire with close ended questions and documentary review for data gathering. SPSS version 23 was used for data analysis and both descriptive and inferential analysis was employed.
Results: In this study total number of participants was 400, with a 100% responses rate. Participants were aged from 17 to 45 years with mean age (SD) 28.78 (±6.296). The prevalence of severe preeclampsia among post-delivery women in Zanzibar was 105 (26.3%). After adjusting for the confounders findings have shown that maternal age group of 15-20 years was associated with severe preeclampsia (AOR 3.839; C.I 1.037-14.210). Pregnancy from new partner/husband (AOR 7.561; C.I 3.883- 14.724). Family history of high blood pressures (AOR 6.446; C.I 3.217-12.917) Furthermore the current study has revealed that severe preeclampsia is significantly associated with low birth weight (AOR 2.845; C.I 1.403-5.769), low Apgar score (birth asphyxia) (AOR 4.385; C.I 2.299-8.362) still birth (AOR 9.199;C.I 2.946- 28.722), Neonatal Intensive Care Unit admission (AOR14.923;C.I.4.236-52.568). Conclusions: The prevalence of severe preeclampsia among post-delivery women in Zanzibar is high. Maternal age group of 15-20 years, having pregnancy from new partner/husband, family history of high blood pressure, diabetes prior to conception, having high blood pressure in previous pregnancy, having multiple pregnancies were among common risk factors.