Magnitude of Preeclampsia and its association with Low neonatal Apgar score and other associated factors among preterm babies at SPHMMC, Addis Ababa, Ethiopia.

Abstract

Abstract Background: Preeclampsia is a leading cause of maternal and neonatal morbidity and mortality, particularly in low-resource settings. Its impact on neonatal outcomes, including Apgar scores, is of significant clinical concern, especially among preterm deliveries. Objective: This study aims to determine the prevalence of preeclampsia and assess its association with neonatal Apgar scores among preterm deliveries at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. Methods: A retrospective cross-sectional study was conducted using medical records of 173 preterm deliveries from January 2023 to January 2025. Bivariate analysis using Chi-square tests and multivariable logistic regression were employed to identify independent predictors of low Apgar scores (<7). All statistical analyses were performed using SPSS version 27. Results: The prevalence of preeclampsia among preterm deliveries was 38.7%. In the multivariable analysis, preeclampsia was found to be a potent independent predictor of low neonatal Apgar score. Neonates born to mothers with preeclampsia had nearly 6 times higher odds of a low 1st-minute Apgar score (AOR = 5.78, 95% CI: 2.50–13.37, p < 0.001) and 2.5 times higher odds of a low 5th-minute Apgar score (AOR = 2.58, p = 0.042) compared to those born to normotensive mothers. Other significant predictors of low neonatal APGAR score include birth weight <1500g (p < 0.001) and early gestational age (p = 0.018). Conclusion: Preeclampsia significantly compromises immediate neonatal adaptation in preterm births. The high risk of low Apgar scores underscores the need for specialized neonatal resuscitation teams. Keywords: Preterm Birth,Preeclampsia, neonatal Apgar score, Ethiopia, Addis Ababa, SPHMMC.