# APBA Kısa Özet

This multicenter prospective cross-sectional study investigated 469 parturients across 17 hospitals in the Dominican Republic to identify risk factors associated with preeclampsia and evaluate their relationship with maternal and perinatal outcomes. Multivariable logistic regression analysis identified chronic hypertension (adjusted OR [AOR], 3.64; 95% CI, 2.25-5.88), a family history of preeclampsia (AOR, 2.86; 95% CI, 1.85-4.42), and pregestational obesity (AOR, 2.26; 95% CI, 1.52-3.36) as independent predictors of preeclampsia (all p < 0.05). Preeclampsia was significantly associated with prematurity (54.6% vs 33.4%; OR, 2.40; 95% CI, 1.62-3.55) and low birth weight (37.6% vs 18.5%; OR, 2.65; 95% CI, 1.73-4.07), though maternal and fetal mortality were not significantly associated with the condition.

# Çalışma neyi araştırdı?

The primary objective of this research was to identify demographic and clinical risk factors contributing to the development of preeclampsia in the Dominican Republic and to measure the impact of this condition on maternal and perinatal morbidity. Specifically, the independent effects of chronic hypertension, a family history of preeclampsia, and pregestational obesity were examined.

# Yöntem

  • Study Design: Multicenter prospective observational cross-sectional analysis.
  • Sample: 469 parturients collected from 17 hospitals over a 30-day period.
  • Data Collection: Demographic, obstetric, and laboratory data were extracted from clinical records and patient questionnaires.
  • Statistical Analysis: Univariate comparisons used the chi-square test; multivariable logistic regression models were used to assess the risk of preeclampsia. The significance threshold was set at p < 0.05.

# Temel bulgular

  • Preeclampsia prevalence: The prevalence of preeclampsia within the study population was reported, with distributions of risk factors between preeclampsia-positive and preeclampsia-negative groups.
  • Chronic hypertension: 44.15% in the preeclampsia group vs. 16.87% in the control group; univariate OR 3.91 (95% CI, 2.51-6.09). In the multivariable model, AOR 3.64 (95% CI, 2.25-5.88).
  • Family history of preeclampsia: 42.0% in the preeclampsia group vs. 19.38% in the control group; univariate OR 3.01 (95% CI, 1.96-4.62). Multivariable AOR 2.86 (95% CI, 1.85-4.42).
  • Gestational obesity: Multivariable AOR 2.26 (95% CI, 1.52-3.36).
  • Prematurity: 54.6% in preeclampsia cases vs. 33.4% in controls; OR 2.40 (95% CI, 1.62-3.55).
  • Low birth weight: 37.6% in preeclampsia cases vs. 18.5% in controls; OR 2.65 (95% CI, 1.73-4.07).
  • Mortality: Maternal and fetal mortality were not significantly associated with preeclampsia.

# Bulgular ne anlama geliyor?

Chronic hypertension, a family history of preeclampsia, and gestational obesity emerged as independent and strong risk factors for the development of preeclampsia. These findings support the notion that hemodynamic and metabolic dysfunctions play a combined role in preeclampsia pathogenesis. Additionally, the increased odds of prematurity and low birth weight associated with preeclampsia underscore its negative effects on fetal growth and maturation. The lack of a significant association with mortality, however, may reflect the short observation window and limited sample size of this study; thus, a true protective effect cannot be ruled out and should be clarified through larger, longitudinal studies.

# Klinik önem

  • Risk Stratification: In pregnant women, the presence of chronic hypertension, a family history of preeclampsia, and obesity should prompt systematic screening for preeclampsia risk during routine prenatal evaluations.
  • Patient Education: Particularly for modifiable risk factors like obesity, weight management and lifestyle interventions during the preconception period may reduce risk; however, this study did not directly measure intervention effects.
  • Perinatal Monitoring: Women diagnosed with preeclampsia may require more frequent fetal monitoring and early delivery planning against the backdrop of increased risk for prematurity and low birth weight.
  • Health Policy: Given the high prevalence of hypertension and obesity in the Dominican Republic population, early diagnosis and management of risk factors at the public health level could reduce the incidence of preeclampsia.

# Sınırlılıklar

  • Short data collection period: The 30-day observation period may be insufficient to capture seasonal and regional variables.
  • Cross-sectional design: Causal relationships cannot be established; only associative findings are presented.
  • Geographic limitation: The study was conducted exclusively in hospitals in the Dominican Republic, limiting the generalizability of findings to other countries or different health systems.
  • Mortality data: Statistical power for mortality analysis may have been insufficient, limiting the conclusiveness of the results.
  • Conflict of interest: The declaration of conflict of interest in this study is unclear, which may introduce an additional layer of uncertainty in the interpretation of findings.

APBA commentary: While this study provides a regional perspective on preeclampsia risk factors, it does not provide evidence that directly changes clinical practice. The identification of risk factors may add a layer to existing prenatal screening protocols, but more comprehensive, prospective cohort studies are needed to inform intervention strategies and long-term outcomes.