Association between Prenatal Control and the Incidence of Preeclampsia in Ecuadorian Pregnant Women: A Cross-Sectional Study

Abstract

Hypertensive disorders are one of the main complications that affect pregnancy, which makes them one of the most important causes of high maternal and fetal morbimortality. Approximately 80% of cases occur at term gestational age, while the remaining percentage begin at earlier gestational ages. Most cases of preeclampsia occur in healthy pregnant women. Therefore, it is important to establish the risk factors in prenatal control visits. Prenatal control is fundamental in which comprehensive surveillance of the pregnant woman is performed. It is known that hypertension in pregnancy is a frequent and potentially dangerous complication for the mother, fetus and newborn. For this reason, one of the objectives of prenatal care is to detect pre-pregnancy hypertension and pregnancy-induced hypertension syndrome (preeclampsia). A nationally representative sample of 20648 mothers from the National Health and Nutrition Survey 2018 (ENSANUT) was used. We used multicollinearity tests to rule out possible statistical modeling problems and a binary logistic linear regression model where Odds Ratio (OR) with their 95% confidence intervals (95% CI) were estimated for each of the independent variables. In addition, we used specificity tests to test the fit between our dependent and independent variables. Our results reveal that prenatal control reduced 2 times (OR= -2.0005; CI=-1.981;-2.055) the probability of suffering complications during pregnancy such as preeclampsia. This result is statistically significant (p<0.05). It was also demonstrated that women from rural areas, with lower income and low schooling are more susceptible to suffer complications during pregnancy compared to the rest of the population. Preeclampsia-eclampsia continues to be one of the pathologies that has the greatest impact on maternal and perinatal morbidity and mortality, so work should continue to find ways to prevent its onset or modify its evolution, avoiding eclampsia or other severe forms of the disease. The results found in this study showed that adequate prenatal care (more than five visits starting in the first trimester of pregnancy) has an impact on the prevention of pregnancy complications such as preeclampsia, since identifying and avoiding it is one of the main purposes of prenatal care.