Prevalence and materno-fetal outcomes of preeclampsia/eclampsia among pregnant women in Nigeria: a systematic review and meta-analysis

Abstract

Preeclampsia and eclampsia (PE/E) are hypertensive disorders of pregnancy with significant morbidity and mortality for both mothers and fetuses. This study aimed to investigate the prevalence of PE/E, associated complications, and mortality rates in pregnant women in Nigeria using a systematic review and meta-analysis approach. A search strategy was employed to identify relevant studies published in English from electronic databases like PubMed, Google Scholar, Science Direct, AJOL, DOAJ and Cochrane Library. Studies investigating the prevalence of PE/E, associated complications, and mortality rates in pregnant women in Nigeria were included. Data extraction and quality assessment were conducted using standardized tools. Pooled prevalence estimates were calculated using random-effects models. Statistical heterogeneity was assessed using the I2 statistic. Publication bias was evaluated using the Egger test. The analysis revealed a pooled prevalence of 4.51% (95% CI 3.82–5.29) for preeclampsia and 1.39% (95% CI 1.02–1.84) for eclampsia in Nigerian pregnant women. Significant heterogeneity was observed for both PE (I2 = 99.20%, P < 0.001) and eclampsia (I2 = 97.43%, P < 0.001). The pooled maternal mortality rate associated with PE/E was 6.04% (95% CI 3.67–8.89), and the fetal mortality rate was 16.73% (95% CI 12.04–22.00). Analysis of complications associated with PE/E revealed a prevalence of 6.37% (95% CI 3.34–10.22) for acute kidney injury, 3.00% (95% CI 1.43–5.06) for cerebrovascular accident (stroke), 3.98% (95% CI 0.61–9.68) for puerperal sepsis, and 5.26% (95% CI 2.24–9.31) for aspiration pneumonia. This study identified a significant burden of PE/E and associated complications in Nigerian pregnant women. High maternal and fetal mortality rates highlight the critical need for improved strategies in Nigeria. Future research should focus on identifying Nigerian-specific risk factors and implementing standardized diagnostic criteria.