Publication:

Maternal and fetal outcomes in early-onset severe preeclampsia: a cross-sectional study from a tertiary care centre in Assam

Background Early-onset severe preeclampsia is associated with significant maternal and fetal risks due to its aggressive progression, which necessitates immediate termination, for maternal safety. This study aimed to evaluate and compare maternal and fetal outcomes in early-onset versus late-onset severe preeclampsia.

Methods A prospective, hospital-based, cross-sectional study was conducted over one year at a tertiary care centre in Assam. A total of 135 pregnant women with severe preeclampsia were enrolled, of whom 44 had early-onset and 91 had late-onset disease. Maternal outcomes (e.g., eclampsia, Hemolysis Elevated Liver Enzymes Low platelets (HELLP) syndrome, pulmonary edema, acute kidney injury, disseminated intravascular coagulation, abruptio placenta, death) and fetal outcomes (e.g., intrauterine fetal demise, fresh still birth, respiratory distress syndrome, Neonatal Intensive Care Unit (NICU) admission, intrauterine growth retardation, neonatal death) were compared. Data were analyzed by using appropriate statistical tests (SPSS 16 version); p<0.05 was considered significant.

Results Maternal complications were significantly more common in early-onset cases (59.1%) compared to late-onset controls (20.87%) (OR=6.03, p<0.0001). Maternal deaths occurred in 4.5% of cases and 1.09% of controls (OR=4.14, p=0.258). Fetal/neonatal death was significantly higher in early-onset cases (18.2%) than in controls (3.29%) (OR=6.30, p=0.0065). NICU admission (54.5% vs. 12.08%) and preterm delivery before 34 weeks were more frequent in early-onset cases.

Conclusions Early-onset severe preeclampsia is associated with markedly increased maternal and fetal morbidity and mortality compared to late-onset severe preeclampsia. Early screening and diagnosis, close monitoring, and judicious timing of delivery are essential to improve outcomes in this high-risk group.