AWARENESS AND PREVENTION OF FACTORS RESPONSIBLE FOR PRE-ECLAMPSIA AMONGST PREGNANT WOMEN ATTENDING ANTENATAL CLINIC IN UBTH

Abstract

This study investigated the awareness and prevention of factors responsible for pre-eclampsia among pregnant women attending antenatal clinics at the University of Benin Teaching Hospital (UBTH). Adopting a cross-sectional survey research design, the study aimed to assess the level of knowledge about pre-eclampsia, including its symptoms, risk factors, and preventive strategies. Data were collected from a sample of 133 pregnant women using a structured questionnaire, and the results were analyzed using the Statistical Package for Social Sciences (SPSS) version 27. The findings indicated that while a majority of respondents demonstrated a general awareness of pre-eclampsia, critical gaps persisted in their understanding of specific preventive measures and early detection strategies. Although antenatal education significantly contributed to awareness levels, the study revealed that it often lacked depth in addressing key issues such as lifestyle modifications, the importance of regular blood pressure monitoring, and recognition of early warning signs like persistent headaches and swelling. The study concluded that while awareness among pregnant women at UBTH was commendable, more intensive and targeted educational interventions were needed to bridge the knowledge gaps. Recommendations included enhancing antenatal education programs, developing culturally sensitive educational materials, conducting community outreach initiatives, and ensuring routine screenings for pre-eclampsia during antenatal visits. These findings highlight the critical role of education and early interventions in reducing the incidence of pre-eclampsia and improving maternal and fetal health outcomes, particularly in resource-constrained settings.

CHAPTER ONE

1.0 Introduction

Pre-eclampsia, a hypertensive disorder of pregnancy, is a major contributor to maternal and neonatal morbidity and mortality worldwide. Characterized by elevated blood pressure and proteinuria after 20 weeks of gestation, this condition poses serious risks to both the mother and fetus, including preterm delivery, low birth weight, and life-threatening complications like eclampsia and organ failure. Despite advances in maternal healthcare, pre-eclampsia remains a significant concern in low- and middle-income countries, where healthcare access and awareness are limited. As Duley (2021) highlights, the global burden of pre-eclampsia disproportionately affects women in resource-constrained settings, underscoring the need for improved healthcare delivery systems.

In Nigeria, pre-eclampsia is a leading cause of maternal deaths, with its prevalence heightened by a lack of awareness, inadequate antenatal care, and poor health-seeking behavior. While tertiary hospitals such as the University of Benin Teaching Hospital (UBTH) provide comprehensive antenatal services, gaps remain in educating pregnant women about the risk factors and preventive measures for pre-eclampsia. According to Akeju et al. (2024), community perceptions and understanding of pre-eclampsia in Nigeria often reflect broader challenges in public health awareness and engagement, particularly in rural and urban low-income settings. This study aims to assess the awareness and prevention strategies regarding pre-eclampsia among pregnant women attending antenatal clinics at UBTH, offering insights into how education and healthcare interventions can improve maternal outcomes.

1.1 Background to the Study

Pre-eclampsia is a prevalent and potentially life-threatening condition that complicates approximately 5–8% of pregnancies globally, according to international health statistics. This condition is characterized by hypertension and proteinuria that typically emerge after 20 weeks of gestation. The underlying pathology is linked to abnormal placental development and function, which impairs the maternal body's ability to adapt to pregnancy. This dysfunction initiates a cascade of vascular and inflammatory responses that place both the mother and fetus at significant risk. The World Health Organization (WHO) recognizes pre-eclampsia as a major contributor to maternal morbidity and mortality, particularly in sub-Saharan Africa, where healthcare infrastructure often struggles to meet the needs of expectant mothers.

The factors that predispose women to pre-eclampsia are multifaceted. Key contributors include advanced maternal age, obesity, multiple pregnancies, a history of pre-existing hypertension, and a genetic predisposition to hypertensive disorders of pregnancy. These risk factors are not uniformly distributed, with certain demographic groups being disproportionately affected due to social determinants of health. For example, women in low- and middle-income countries (LMICs) often lack access to routine healthcare services, which increases their vulnerability to pregnancy-related complications. This disparity underscores the need for tailored healthcare interventions that address both biological and socio-economic risk factors.

Nigeria, the most populous nation in Africa, bears a significant burden of maternal mortality, with pre-eclampsia identified as one of the leading causes of these deaths. The maternal mortality ratio in Nigeria remains among the highest globally, despite efforts to improve maternal health services. In many cases, limited awareness of pre-eclampsia exacerbates its impact. Women may not recognize the early warning signs, such as persistent headaches, swelling, or visual disturbances, leading to delays in seeking medical care. Additionally, many health facilities, especially in rural areas, lack the resources and trained personnel necessary to manage pre-eclampsia effectively.

Pre-eclampsia’s effects extend beyond maternal health, profoundly impacting fetal development. The condition disrupts the supply of oxygen and nutrients to the fetus due to impaired placental function, increasing the risk of adverse outcomes such as intrauterine growth restriction (IUGR), preterm delivery, and stillbirth. Neonates born to mothers with pre-eclampsia often require specialized care, placing an additional strain on healthcare systems that are already overburdened. These challenges highlight the urgent need for preventive strategies and early interventions to mitigate the condition's impact.

As noted by Osungbade and Ige (2021), addressing the public health implications of pre-eclampsia in developing countries requires a multifaceted approach. This includes enhancing healthcare infrastructure, improving antenatal care coverage, and increasing awareness of maternal health issues among women of reproductive age. Strengthening healthcare systems is particularly crucial, as many facilities in Nigeria lack the capacity to provide comprehensive antenatal care services. Additionally, targeted educational initiatives can empower women to recognize the signs of pre-eclampsia and seek timely medical attention, potentially reducing the condition's prevalence and severity.

Antenatal care represents a critical platform for combating pre-eclampsia, offering opportunities for early detection and intervention. Routine monitoring of blood pressure and urine protein levels, combined with comprehensive education on risk factors and preventive measures, can significantly improve maternal outcomes. However, studies have revealed gaps in the knowledge and awareness of pre-eclampsia among pregnant women attending antenatal clinics. This lack of awareness often results in missed opportunities for early diagnosis and management, which are essential for preventing complications.

The University of Benin Teaching Hospital (UBTH) is one of Nigeria's leading tertiary healthcare institutions, providing specialized antenatal care services to a diverse population of pregnant women. Despite the availability of these services, many women remain inadequately informed about pre-eclampsia. This gap in knowledge underscores the need for targeted educational initiatives within healthcare settings. Effective health education programs can empower women to take proactive measures in managing their pregnancies, thereby reducing the risk of complications.

This study focuses on assessing the level of awareness and the preventive measures adopted by pregnant women attending antenatal clinics at UBTH. By evaluating their understanding of pre-eclampsia and identifying gaps in knowledge, the study aims to inform the development of targeted interventions that can improve maternal and neonatal health outcomes. The findings of this research have the potential to guide healthcare policies and practices, ultimately contributing to the reduction of maternal mortality in Nigeria.

1.2 Statement of the Problem

Pre-eclampsia continues to pose a serious threat to maternal and fetal health, particularly in resource-limited settings like Nigeria. Despite the availability of antenatal care services at UBTH, many pregnant women remain unaware of the risk factors, symptoms, and preventive measures associated with pre-eclampsia. This lack of awareness contributes to delayed medical intervention, increasing the risk of severe complications and maternal mortality.

Efforts to reduce maternal deaths in Nigeria must address this gap by enhancing education and prevention strategies for pre-eclampsia. Without adequate knowledge, pregnant women cannot make informed decisions about their health, nor can they recognize early warning signs of the condition. This study seeks to address this critical issue by assessing the awareness of pre-eclampsia among pregnant women at UBTH and identifying ways to improve preventive measures.

1.3 Research Questions

1. What is the level of awareness among pregnant women attending UBTH antenatal clinics regarding the risk factors for pre-eclampsia?
2. Are pregnant women attending UBTH antenatal clinics aware of the symptoms and preventive measures for pre-eclampsia?
3. How can antenatal education programs improve awareness and prevention of pre-eclampsia among pregnant women at UBTH?

1.4 Objectives of the Study

The study aims to assess awareness and prevention strategies for pre-eclampsia among pregnant women attending antenatal clinics at UBTH. The specific objectives are:

1. To evaluate the level of awareness of pre-eclampsia risk factors among pregnant women at UBTH.
2. To assess the knowledge of symptoms and preventive measures for pre-eclampsia among pregnant women at UBTH.
3. To explore the role of antenatal education in improving awareness and prevention of pre-eclampsia.

1.5 Significance of the Study

This study holds considerable significance for various stakeholders, including healthcare professionals, pregnant women, and society at large. The insights it generates have the potential to improve maternal and neonatal health outcomes, particularly in Nigeria, where pre-eclampsia remains a leading cause of maternal mortality. The significance of this research can be categorized as follows:

The study's findings will serve as a valuable resource for healthcare providers, particularly those working in antenatal care settings. By identifying gaps in awareness and understanding of pre-eclampsia among pregnant women, the study will guide the development of effective educational programs tailored to address these deficiencies. Such programs will focus on preventive strategies, early detection, and timely intervention, thereby enhancing the quality of antenatal care. Additionally, the study will contribute to the body of knowledge within the healthcare profession, fostering evidence-based practices in maternal health care delivery.

One of the study's core objectives is to highlight areas where communication between healthcare professionals and pregnant women can be improved. Effective communication is crucial for ensuring that pregnant women receive accurate, timely, and accessible information about pre-eclampsia. This study will shed light on the current challenges in disseminating such information and propose practical solutions for addressing them. For instance, it may recommend the use of culturally sensitive educational materials, visual aids, or group sessions to improve the understanding of pre-eclampsia risk factors and symptoms among diverse patient populations.

Raising awareness about pre-eclampsia is not only essential for individual health outcomes but also for the broader societal goal of reducing maternal and neonatal mortality rates. Women who are informed about the risks and early signs of pre-eclampsia are better equipped to seek timely medical attention, adhere to recommended antenatal care schedules, and adopt preventive measures. This empowerment leads to healthier pregnancies and contributes to the overall well-being of families and communities.

Beyond the immediate benefits for patients and providers, this study underscores the importance of public health interventions in addressing maternal health challenges. By reducing the burden of pre-eclampsia, the study aligns with global efforts to achieve sustainable development goals (SDGs), particularly those related to maternal and child health. Ultimately, this research aims to contribute to the creation of a more informed, healthier society.

1.6 Scope of the Study

The study focuses on pregnant women attending antenatal clinics at the University of Benin Teaching Hospital (UBTH) in Benin City, Edo State, Nigeria. The study assesses the level of awareness and prevention strategies for pre-eclampsia, examining variables such as awareness of risk factors, symptoms, and preventive measures. The population includes all pregnant women attending antenatal clinics at UBTH during the study period, while the study excludes women who are not attending antenatal clinics or who have already been diagnosed with pre-eclampsia.

1.7 Operational Definition of Terms

1. Pre-eclampsia: A pregnancy-related hypertensive disorder characterized by elevated blood pressure and proteinuria after 20 weeks of gestation.
2. Antenatal Care (ANC): Regular medical check-ups and health education provided to pregnant women to monitor and promote maternal and fetal well-being.
3. Risk Factors: Conditions or characteristics that increase the likelihood of developing pre-eclampsia, such as obesity, advanced maternal age, or multiple pregnancies.
4. Symptoms: Clinical signs of pre-eclampsia, including severe headaches, swelling, high blood pressure, and protein in the urine.
5. Preventive Measures: Strategies to reduce the risk of developing pre-eclampsia, such as maintaining a healthy lifestyle, regular medical check-ups, and managing pre-existing conditions.
6. Awareness: The level of knowledge and understanding a person has about a particular subject, in this case, pre-eclampsia.
7. University of Benin Teaching Hospital (UBTH): A tertiary healthcare facility in Benin City, Nigeria, providing specialized maternal and child health services.
8. Maternal Mortality: The death of a woman during pregnancy, childbirth, or within 42 days of delivery, often due to complications such as pre-eclampsia.