Risk factors of pulmonary edema in women with preeclampsia from south India: a case-control study

Pulmonary edema is a potentially life-threatening complication of preeclampsia, but only few studies have looked at possible risk factors. This study assessed the association between various potential risk factors and the development of pulmonary edema. An age-matched case-control design with hospital records from a tertiary care center in south India was used. A total of 55 pregnant women with preeclampsia who developed pulmonary edema were included as cases, who were 4:1 aged-matched as controls with 220 preeclamptic women, and who did not develop pulmonary edema. Multivariate conditional logistic regression was used to produce adjusted odds ratios with 95% confidence intervals for the likelihood to develop pulmonary edema (OR; 95% CI). Nulliparity (3.94; 1.44-10.7), multifetal pregnancy (5.06; 1.59-16.0), mean arterial blood pressure in mmHg (1.08; 1.03-1.13), and mild (3.25; 1.02-1.29) and moderate (4.43; 1.76-11.1) anemia showed increased odds. Multifetal pregnancy in nulliparous women had higher odds (39.5; 6.2-251) compared with those with singleton pregnancies (3.17; 1.13-8.88). While early aggressive blood pressure treatment can reduce the risk of pulmonary edema, the other risk factors are either non-modifiable or relate to disease severity; thus, continuous monitoring would be relevant for early diagnosis and management, especially among nulliparous preeclamptic women with multifetal pregnancies.