Date of Award

12-2023

Degree Type

Thesis

Degree Name

Master of Science in Advanced Practice Midwifery (MSc-APM)

First Advisor

Dr. Abednego Ongeso

Second Advisor

Lucy Kisaka

Third Advisor

Prof. Eunice Ndirangu

Department

School of Nursing and Midwifery, East Africa

Abstract

Background: Preeclampsia is a life-threatening pregnancy illness characterised by the onset of hypertension in a non-hypertensive woman after 20 weeks of pregnancy. Studies have connected preeclampsia to significant adverse effects on the mother and the newborn, a common obstetric emergency in Kenya. Determinants of poor perinatal outcomes in babies born to preeclamptic mothers have not been intensively investigated.

Objective: The study evaluated the determinants of perinatal outcomes among neonates born to mothers diagnosed with preeclampsia at Mama Lucy Kibaki Hospital between July 2021 and June 2022.

Methodology: A quantitative retrospective cross-sectional inquiry was conducted. Data reviewed comprised records of neonates born after 28 weeks gestation to term and within a week post-delivery. The research omitted records of neonates born of preeclampsia with comorbidities and multiple gestation. SPSS version 25 was utilised for analysis. Demographic, obstetric, and neonatal factors were analysed using descriptive statistics. The inferential statistics using a chi-square test were employed to establish perinatal mortality risks and variables.

Results: The likelihood of poor perinatal outcomes was significantly more when babies were delivered preterm (OR=8.9, 95% CI=3.4-22.0), p < 0.001), when mothers were referred for specialised care (OR=2.9, 95% CI=1.3-7.1, p=0.001), and when mothers had a spontaneous vaginal delivery (OR=7.3, 95% CI = 3.1-16.5, p < 0.001). The likelihood of poor perinatal outcomes was also higher when babies were underweight (< 2500 grams) (OR=5.7, 95% CI=2.3-14.8, p< 0.01) and were delivered by students compared to skilled birth attendants (OR=9.3, 95% CI=2.3-38.0, p=0.001).

Conclusions: The main predisposing factors include low birth weight, preterm delivery, being underweight, the need for specialised care, and delivery by students, compared to skilled birth attendants. High-risk mothers should be monitored throughout pregnancy, and babies should be delivered via the caesarian section to lower the incidence of poor perinatal outcomes. Delivery by students and trainees should be under supervision.

First Page

1

Last Page

106

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