Outcomes of Early-onset Preeclampsia With Severe Features at the University Hospital in Southern Thailand: a 15-year Experience

Abstract Purpose: To evaluate outcomes and factors associated with adverse outcomes among patients with early-onset preeclampsia with severe features at Songklanagarind Hospital. Methods: A retrospective study of 326 singleton women with early-onset preeclampsia with severe features treated at Songklanagarind Hospital between 2004-2019 was conducted. Baseline characteristics, management and outcomes were reviewed. Multivariate logistic regression was used to evaluate predictors of adverse outcomes. Statistical significance was set at p < 0.05.Results: There were no maternal mortalities, with 3.1% stillbirths and 6.7% neonatal deaths. High maternal serum creatinine (OR 3.26, 95% CI 1.27-8.36, p = 0.01) was significantly associated with adverse maternal outcomes. Early gestational age at delivery [< 28 weeks (OR 16.63, 95% CI 6.95-39.80, p <0.01), 28-32 weeks (OR 3.24, 95% CI 1.54-6.85, p <0.01)], maternal diabetes mellitus (OR 5.62, 95% CI 1.43-22.06, p = 0.01), high maternal serum creatinine (OR 2.66, 95%CI 1.20-5.93, p = 0.02) and elevated serum aminotransferases (OR 2.26, 95% CI 1.19-4.29, p = 0.01) were associated with serious adverse perinatal outcomes.Conclusions: Early-onset preeclampsia with severe features had favorable outcomes. Maternal diabetes mellitus, high serum creatinine, elevated serum aminotransferases and early gestational age at delivery were factors associated with poor outcomes.