Prevalence and risk factors associated with severe features of pre-eclampsia among women in Thailand

The objective of this study is to investigate the prevalence of and identify risk factors associated with pre-eclampsia with severe features (sPE) and model such data to generate a predictive risk score.

This retrospective case-control study was conducted at Bhumibol Adulyadej Hospital (BAH), between January 2017 and December 2024. Participants were pregnant women who delivered at BAH. Subjects who were diagnosed with sPE and normal were classified as the study and control groups. Data was collected from medical records.

There were 30,620 deliveries during the study period. A total of 546 sPE cases were recruited. There were 500 participants in each group. The significant risk factors associated with sPE were BMI ≥ 25 kg/m2 (aOR: 2.05, 95%CI: 1.43-2.93), age ≥35 years (aOR: 2.33, 95%CI: 1.55 - 3.47), illicit drug use (aOR: 6.47, 95%CI: 2.29 - 18.33), chronic hypertension (CHT, aOR: 10.24 , 95%CI: 4.71, 22.26), diabetes mellitus (DM, aOR: 8.58, 95% CI: 2.46 - 29.93), familial history of hypertension (FHT, aOR: 1.62, 95% CI: 1.1- 2.37) and previous history of preeclampsia (PEPP, aOR: 13.42, 95% CI: 2.95 - 61.04).The cut-off was established at a score of ≥ 4, which provided sensitivity, specificity, positive and negative predictive value, and accuracy at 54.2, 87.0, 80.7, 65.5 and 70.6 percent respectively.

The prevalence of sPE was 17.8 per 1,000 deliveries. PEPP, CHT, DM, illicit drug use, advanced age (≥35 years), BMI ≥25 and FHT were associated with higher risk of sPE development at aOR of 13.42, 10.24, 8.58, 6.47, 2.3, 2.05 and 1.62, respectively.