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.