Publication:

Comparative analysis of maternal and neonatal outcomes in early versus late onset pre-eclampsia: a prospective study from northern India

Background Pre-eclampsia, a leading hypertensive disorder in pregnancy, significantly contributes to maternal and neonatal morbidity and mortality. It is categorized into Early-Onset Pre-Eclampsia (EOPE, <34 weeks) and Late-Onset Pre-Eclampsia (LOPE, ≥34 weeks), differing in risk factors, clinical profiles, and outcomes. This study compared EOPE and LOPE regarding risk factors, laboratory findings, and maternal and neonatal outcomes.

Methods A prospective study was carried out from April, 2021 to March, 2022 at Kamla Nehru State Hospital for Mother and Child, IGMC, Shimla, including 184 pre-eclamptic women diagnosed as per ACOG 2020 criteria. Participants were divided equally into EOPE (n=92) and LOPE (n=92) groups. Demographics, clinical history, complications and outcomes were analyzed using SPSS 25.0, with significance set at p<0.05.

Results EOPE was associated with younger age (mean 24.79 vs. 26.95 years, p=0.001), primigravidity (62% vs. 37%, p=0.001), chronic hypertension and prior pre-eclampsia. Diabetes was more prevalent in LOPE (21.7% vs. 5.4%, p=0.001). EOPE had higher rates of severe maternal complications, including HELLP syndrome (9.8% vs. 2.2%), eclampsia (20.7% vs. 8.7%) and placental abruption (14.1% vs. 5.4%). Neonates in EOPE had poorer outcomes, with lower birth weight (1.84 kg vs. 2.45 kg, p<0.001), more NICU admissions (90.2% vs. 20.7%, p<0.001) and longer NICU stays (13.69 vs. 1.65 days, p<0.001).

Conclusions EOPE is linked to younger maternal age, primigravidity and severe outcomes, whereas LOPE is associated with metabolic risk factors like diabetes and milder complications. Early identification and tailored management are crucial to improve maternal and neonatal outcomes.