Preeclampsia severity and associated factors in Kelantan, Malaysia

Aims: Preeclampsia is a significant disorder that poses serious risks to maternal and fetal health. This study aimed to identify the severity of preeclampsia and associated factors in a University Hospital in Malaysia. Methods: A cross-sectional study was conducted among preeclampsia patients at the Hospital Universiti Sains Malaysia (USM), Kelantan, Malaysia, between 2011 and 2016. Preeclampsia patients with chronic hypertension, hemolysis, elevated liver enzymes, low platelet (HELLP) syndrome, and eclampsia were included, whereas patients with chronic kidney disease were excluded. Preeclampsia severity was classified into mild, moderate, and severe. Results: The study included 202 patients [mean (standard deviation) maternal age: 30.49 (6.18) years]. Most patients were multigravida (134) and multipara (134). Sixty-five (32.2%) patients had a history of preeclampsia. The proportion of patients with mild preeclampsia was 35% [95% confidence interval (CI): 30%, 40%], moderate preeclampsia was 30% (95% CI: 25%, 35%), and severe preeclampsia was 35% (95% CI: 30%, 40%). High levels of uric acid [adjusted odds ratio (OR): 1.05, 95% CI: 1.02, 1.07, p=0.001], chronic hypertension (adjusted OR: 2.36, 95% CI: 1.28, 4.33, p=0.006), and gestational diabetes mellitus (adjusted OR: 0.53, 95% CI: 0.30, 0.96, p=0.035) were the factors associated with the severity of preeclampsia. Conclusions: Higher levels of uric acid, chronic hypertension, and gestational diabetes mellitus were significantly associated with the severity of preeclampsia among patients in the USM.