Outcomes and Risk Factors for Preeclampsia with Severe Features Following the Implementation of a Management Guideline for Hypertensive Disorders in Pregnancy at Ban Mi Hospital.
Keywords:
Hypertension in pregnancy, severe features, Preeclampsia, Pregnancy outcomes, Risk factors, Magnesium sulfate, Low-dose aspirinAbstract
This study aimed to evaluate the outcomes of implementing clinical guidelines for managing pregnant women with hypertension and to identify risk factors for severe features following guideline implementation. A retrospective study was conducted by reviewing medical records of 192 pregnant women diagnosed with preeclampsia who delivered at Ban Mi Hospital between October 1, 2020, and September 30, 2024. Data were collected using a self-developed record form, including personal characteristics, pregnancy-related factors, clinical factors, delivery outcomes, and other relevant variables. Data were analyzed using descriptive statistics, t-test, Chi-square, and multivariable logistic regression.
The results showed that women with severe features had higher pre-pregnancy BMI, fewer antenatal care visits, later gestational age at first antenatal visit, early-onset hypertension, and comorbidities such as gestational diabetes, chronic hypertension, and multiple gestations. These factors were significantly associated with an increased risk of severe preeclampsia (Adjusted OR 2.20–4.20, p<0.05). The severe group also had higher cesarean section rates, greater use of magnesium sulfate, and neonates with lower birth weights and Apgar scores <7 at 5 minutes compared with the non-severe group.
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