Risk factors for pre-eclampsia in Lagos, Nigeria

Background: Pre-eclampsia is an important cause of maternal mortality. Although there have been many studies worldwide on pre-eclampsia, not many have come from black Africa. Study design: A case-control study was conducted in a tertiary hospital in Nigeria (the black African nation with the highest population) between February 2001 and August 2002 to determine the risk factors for eclampsia. Information on socio-demographic characteristics, pre-pregnancy weight, medical history and previous obstetric history, and level of stress at home and at work was obtained by face-to-face interviews. Analysis: Multiple logistic regression analysis was used to determine the risk factors for pre-eclampsia. Results: One hundred and thirty seven (7.6%) of the 1803 women who delivered during the period had pre-eclampsia/eclampsia. Of these, 128 (93.4%) were analysed. Ninety-one (71.1%) women were primigravidae. Age! 19 years was not considered a risk factor. The risk factors that were associated with increased risk of pre-eclampsia were: nulliparity (OR 4.77-3 95% CI 2.90-7.78), stressful work during pregnancy (OR 2.10; 95% CI 1.20-3.71), stressful home environment (OR 1.97; 95% CI 1.27-3.69), previous pre-eclampsia (OR 11.68; CI 3.81-37.61), history of chronic hypertension (OR 2.21; 95% CI 1.17-6.20), a body weight greater than 80 kg (OR 2.01; 95% CI 1.05-3.87); and multiple pregnancy (OR 2.71; 95% CI 1.27-6.13). Conclusions: Risk factors for pre-eclampsia among Nigerian women are not different from those that have been reported in other studies. Weight reduction, good control of chronic hypertension, and reduction of stressful conditions at home and in pregnancy could be steps towards the primary prevention of this disorder.