TIME TO RECOVERY FROM ECLAMPSIA, AND ITS PREDICTORS AMONG PREGNANT AND POSTPARTUM MOTHERSADMITTED TO SELECTED PUBLIC HOSPITALS OF HARARI REGION AND DIRE DAWA CITY ADMINISTRATION, EASTERN ETHIOPIA

Abstract

Background:Eclampsia is defined by a sudden onset of generalized tonic-clonic convulsions in a patient having signs and symptomsof preeclampsia. Mothers with eclampsia can face potentially fatal complications such as acute renal failure, aspiration pneumonitis, abrupt placenta abruption, liver rupture, intracerebral hemorrhage, and acute pulmonary edema.Even though there is a high burden of eclampsia, there is limited evidence on the time to recover from eclampsia and its predictors in EasternEthiopia. Objective:This study aimed to assess the time to recovery from eclampsia, and its predictors among pregnant and postpartum women admitted to public hospitals of Harari Region and DireDawa Administration from January 1, 2017, to December 31, 2022. Methods:An institution-based retrospective cohort study was conducted among 475 eclamptic women and data was collected by reviewing their records. A simple random sampling method was used to select cards of patients. The data were entered using Epidata version 4.6 and analyzed by STATA 17. The probability of time to recovery was estimated using the Kaplan-Meier failure curve, and the equivalence of failure functions across explanatory variables was tested using the log-rank test. A Weibull PH regression model was used to identify the predictors of time to recovery. A multicollinearity was checked using the variance inflation factor (VIF= 3.30).Factors significantly associated with the outcome variable in bi-variable analysis at a p-value less than 0.25 were included in the multivariable analysis. Statistically significant associations were measured by the adjusted hazard ratio with a 95% confidence interval at a p-value less than 0.05.The goodness of fit of the model was assessed by using the Cox–Snell residual technique. Results:The study found that nine in ten mothers admitted with eclampsia recovered, corresponding to an incidence density of 11.24 per 100 mothers' hours. The median duration of eclampsia of the mothers was 8 hours (IQR: 6, 10). Lack of ANC visits (AHR=0.780, 95%CI: 0.640- 0.9524), being aged ≥ 35 (AHR=0.429, 95%CI: 0.276-0.665), giving birth by cesarean (AHR=0.699, 95%CI: 0.561-0.872), labor started by induction (AHR=1.404: 95%CI: 1.145-1.721), and being a rural resident (AHR=0.732, 95%CI: 0.587-0.913) were independent predictors of time to recovery for eclamptic mothers. Conclusions: The median recovery time from eclampsia among mothers admitted with eclampsia in Eastern Ethiopia is low (8 hours) relatively low based on the previous study. We xiii found that several factors, including age≥ 35 years, being a rural resident, lack of ANC visits, and cesarean delivery, contributed to the extended recovery time for eclamptic mothers in eastern Ethiopia. However, labor induction led to a faster recovery time. To improve the recovery time from eclampsia special focus should be given to mothers who had no ANC visits, rural dwellers, old age, and who gave birth by cesarean.