Maternal Factors Associated with Preeclampsia among Asian: Systematic Review of Large Cohort Studies

Abstract

Background:

Maternal mortality is still a major problem in developing countries. In 2015, World Health Organization estimated the Maternal Mortality Rate (MMR) in developing countries was as high as 239 per 100,000 live births, while it was as low as 12 in developed countries. According to the data, this indicates the failure of many developing countries in achieving Millennium Development Goals (MDG), nevertheless the awareness of which is still low. Moreover, maternal death also immensely affects the growth and development of a child, which can lead to a reduced childs life quality. In fact, 25% of maternal deaths are caused by Preeclampsia, hence it is still a global burden, and has to be controlled to achieve Sustainable Development Goals in 2030. In addition, a population-specific systematic review of maternal factors associated with preeclampsia among Asian has not been done before.

Aim:

This paper reports a systematic review to identify factors associated with preeclampsia among Asian in order to reduce its incidence through increasing awareness and screening quality of preeclampsia.

Material and method:

A systematic review was conducted on cohort studies concerning the factors associated with preeclampsia among Asian. Cohort studies were chosen as it is a time-based study, therefore compatible to identify the risk of preeclampsia, based on pathogenesis during pregnancy time. 6133 records, related with preeclampsia among Asian, were found from Pubmed database. We exclude publications that did not meet inclusion criteria (n = 6037), then which meet exclusion criteria (n = 81). Finally, three reviewers extracted data from total included study (n = 15) and we assested the studies with STROBE statement to show the quality of each studies.

Results:

There were 375.622 participants among 15 studies. The studies show that factors associated with preeclampsia are: maternal BMI, maternal weight gain during pregnancy, maternal age, history of gestational hypertension and preecalmpsia, diabetes mellitus, gravida and parrity, etc. Risk factors with highest odd ratio are pre-gestational obese (OR: 7.85); chronic hypertension (OR: 7.174); and previous history of gestational hypertension or preeclampsia (OR: 8.85). On the other hand, weight gain below IOM in overweight pre-gestational weight (OR: 0.76), isolated anti TPO antibody (OR: 0.7), normal BMI with BPD >90 (OR: 0.86), and maternal weight gain <10kg (OR: 0.5) are shown to be protective factors of preeclampsia. Furthermore, maternal BMI, history of gestational hypertension and preeclampsia are risk factors of preeclampsia which most discussed and could be a complex issues among Asian countries.

Conclusion:

From this systematic review, maternal BMI (overweight and obese), inappropriate maternal weight gain, and history of pre-gestational hypertension and preeclampsia, were proven to be the highest risk of preeclampsia among Asian. Other risks of which are maternal age, mothers education, mother activity, DM and hypothyroidism. With this knowledge, we aim this review to improve the quality of preeclampsia screening and awareness of physicians and mothers regarding the problem or even develop a practical evidence based list of risk factors related to preeclampsia among Asian, which can be assesed by health care worker.

Background:
Maternal mortality is still a major problem in developing countries. In 2015, World Health
Organization estimated the Maternal Mortality Rate (MMR) in developing countries was as high
as 239 per 100,000 live births, while it was as low as 12 in developed countries. According to the
data, this indicates the failure of many developing countries in achieving Millennium
Development Goals (MDG), nevertheless the awareness of which is still low. Moreover, maternal
death also immensely affects the growth and development of a child, which can lead to a
reduced childs life quality. In fact, 25% of maternal deaths are caused by Preeclampsia, hence it
is still a global burden, and has to be controlled to achieve Sustainable Development Goals in
2030. In addition, a population-specific systematic review of maternal factors associated with
preeclampsia among Asian has not been done before.
Aim:
This paper reports a systematic review to identify factors associated with preeclampsia among
Asian in order to reduce it