Post-partum trend in blood pressure levels, renal function and proteinuria in women with severe preeclampsia and eclampsia in Sub-Saharan Africa: a 6-months cohort study.
BACKGROUND
Preeclampsia and eclampsia, which are the most frequent hypertensive disorders in pregnancy, are associated with renal involvements. We aimed to assess the time trend in blood pressure levels, renal function and proteinuria after delivery, and investigate their determinants in Cameroonian women with severe preeclampsia and eclampsia.


METHODS
This was a prospective cohort study involving 54 women with severe preeclampsia and eclampsia, conducted between July 2010 and February 2012 at the central maternity unit of the Yaoundé Central Hospital. Clinical and laboratory parameters were recorded from day-1 to 6 months after delivery. Mixed-linear and logistic regression models were used to relate baseline and within follow-up levels of covariates, with changes in blood pressure levels, renal function and proteinuria, as well as persisting hypertension, renal failure and proteinuria.


RESULTS
During follow-up, a significant improvement was observed in blood pressure, renal function and proteinuria (all p < 0.002). Thirteen (24.1%) patients with renal failure at delivery recovered completely within six weeks. Twenty-six (48.1%), 17 (31.5%) and 1 (1.8%) patients had persisting proteinuria at 6 weeks, 3 months and 6 months post-delivery, respectively. Corresponding figures for persisting hypertension were 23 (42.6%), 15 (27.8%) and 8 (14.8%). Advanced age, higher body mass index, low gestational age at delivery, low fetal birth weight, and proteinuria at delivery were the main risk factors for persisting hypertension at 3 months, meanwhile low fetal birth weight, severe preeclampsia and proteinuria at delivery were correlated with persisting proteinuria at 3 months. Advanced age and higher body mass index were the only determinants of the composite outcome of persisting hypertension or proteinuria at three and six months.


CONCLUSIONS
Hypertension and proteinuria are very common beyond the postpartum period in Cameroonian women with severe preeclampsia and eclampsia. Long-term follow-up of these women will help preventing and controlling related complications.
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences & University Teaching Hospital of Yaoundé, University of Yaoundé 1, Yaoundé, Cameroon. francoiskaze@yahoo.fr.
Francois Folefack
FF
Kaze
Francis A
FA
Njukeng
Andre-Pascal
AP
Kengne
Gloria
G
Ashuntantang
Robinson
R
Mbu
Marie Patrice
MP
Halle
Tazoacha
T
Asonganyi
D000328:Adult; D001794:Blood Pressure; D002163:Cameroon / Q000453:epidemiology; D004461:Eclampsia / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D011446:Prospective Studies; D011507:Proteinuria / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult