Unveiling Preeclampsia: The Risk Factors, Clinical Profiles, and Outcomes in Early vs. Late Onset - A prospective Observational Study

Authors: Pramila Jena, Aishwarya Singh, Subhadra Priyadarshini, Bandita Panda, Aradhana Das, Sibanarayan Rath

DOI: 10.18231/j.ijogr.8638.1762254386

Keywords: Early-onset preeclampsia, late-onset preeclampsia, socio-demographic risk factor, maternal and perinatal complications

Abstract: Background: Preeclampsia is a multifaceted and heterogeneous disorder that occurs during pregnancy, significantly contributing to adverse fetomaternal outcomes and imposing a considerable health burden globally. The objective of this study is to compare the fetomaternal outcomes associated with early-onset preeclampsia (EO-PE) and late-onset preeclampsia (LO-PE), emphasizing the differing risks and clinical characteristics. Methods: A prospective observational study was conducted on 134 preeclampsia diagnosed cases and were grouped into early onset (40) and late onset (94) based on the event of occurance. The clinical behavior and pregnancy outcomes of the two groups were analyzed. The odds ratio with a 95% Confidence interval was estimated by binomial and multinomial logistic regression analysis on maternal and perinatal outcomes. Results: The risk factor profiles of early-onset and late-onset preeclampsia were largely similar. However, the likelihood of developing HELLP syndrome, organ damage, requiring operative delivery, and experiencing prolonged hospital stays was significantly greater in the early-onset group. Adverse perinatal outcomes, including intrauterine fetal demise (IUFD) (22.5% vs. 2.1%, OR=13.355, p=0.001), intrauterine growth restriction (IUGR) (20.0% vs. 3.2%, OR=7.583, p=0.004), respiratory distress (37.5% vs. 11.7%, OR=4.527, p=0.001), jaundice (15.0% vs. 4.3%, OR=3.971, p=0.041), and low birth weight (70.0% vs. 19.1%, OR=9.852, p<0.001), were also significantly more prevalent in the EO-PE cohort. Conclusion: Early onset preeclampsia is associated with a more severe clinical trajectory compared to late-onset preeclampsia, leading to a higher probability of adverse feto-maternal outcomes. Factors such as the gestational age at the onset of the condition, the presence of proteinuria, low platelet counts, elevated uric acid and serum creatinine levels, as well as fetal growth restriction and Doppler abnormalities, significantly indicate the disease severity and its prognosis.