Introduction
Hypertensive disorders of pregnancy (HDP) encompass a heterogeneous
group of conditions including pre-existing hypertension, gestational
hypertension, preeclampsia/eclampsia, and superimposed hypertension.
HDPs are the leading cause of severe morbidity, mortality, and long-term
sequelae for mother and baby1,2. A majority of
maternal and perinatal deaths due to preeclampsia (PE) are preventable
if appropriate treatment is prescribed2,3. Most of the
morbidity occurs among pregnancies complicated by PE or eclampsia and
for every woman who dies, approximately 20 others suffer severe
morbidity4.In Asia, nearly about
1/10th of all maternal deaths are associated with
HDPs3. The burden and the magnitude of PE are not
fully known in some of the places in the world, especially in low- and
middle-income countries. The crude incidence of PE was 2.3%, ranging
from 1.2% to 4.2% across the world regions. Incidence estimates of PE
in the SEARO region varied from 1.9% in Thailand to 8.6% in
Indonesia4. The incidence of PE in developing
countries is about five to seven times higher than that in developed
countries5. A population-based multi-country study
reported the incidence of pre-eclampsia to be 3.8%among pregnant women
in India6. The major risk factors for PE reported are
the previous history of PE, chronic hypertension, pre-gestational
diabetes mellitus, multiple gestations, pre-pregnancy body mass index
(BMI) >30, and few others7.
Most of the available studies evaluated the incidence and risk factors
for PE in healthy pregnant women. Only a few studies evaluated the
incidence among high-risk pregnant women globally. To the best of our
knowledge, this is the first study to evaluate the risk factor and
incidence of PE in a South Indian cohort of high-risk pregnant womenin a
longitudinal follow-up manner. Determining the incidence of PE among
risk group pregnant women isa key to guiding and funding public health
policies aiming towards screening, prophylaxis, early diagnosis, and
treatment, as well as supporting prospective studies related to this
serious maternal disorder. The objective of this study is to assess the
incidence and actual risk factor for PE among the South Indian pregnant
women with risk for developing PE.