Predictors of Preeclampsia and Pregnancy Associated Outcomes Among Pregnant Women: A Prospective Cohort Study in Selected Hospitals in Kiambu County, Kenya

Preeclampsia is a multisystem hypertensive disorder of pregnancy that emerges after 20 weeks of gestation, and remains a leading cause of maternal and perinatal morbidity and mortality globally, yet evidence on its predictors and outcomes in Kenya remains limited. This prospective cohort study compared pregnant women with and without preeclampsia who attended selected hospitals in Kiambu County, to determine the predictors of preeclampsia and its associated maternal and neonatal outcomes. The results indicated a very strong statistical association between preeclampsia and the following i.e parity, time taken to reach the hospital, hypertension and diabetes mellitus (p-value <0.001) and religion (p-value <0.013). Women with preeclampsia had nearly twice the risk and six times the odds of delivering low-birth-weight infants compared with women without preeclampsia (RR = 1.97; OR = 6.25). A strong statistically significant association was observed between multiparity and prematurity (RR = 5.3, OR = 8.4, p < 0.001). Multiparous women with preeclampsia had approximately 5.3 times the risk and 8.4 times the odds of experiencing a premature birth compared with women without preeclampsia. In conclusion preeclampsia significantly increased adverse maternal and neonatal outcomes, highlighting the need for early high-risk pregnancies identification and strengthened antenatal care to improve both maternal and neonatal outcomes.