(820) Associations between non-communicable diseases and obstetric complications at a tertiary referral hospital in southwestern Uganda

We conducted a retrospective cross-sectional study, and randomly selected records of women admitted for delivery at MRRH each month from January to December 2022, extracting their socio-demographic and clinical characteristics. We performed multivariable robust Poisson regression analysis to assess the association between NCDs and obstetric complications. Models were adjusted for maternal age, gravidity, referral status, employment status, and HIV serostatus.

Results:

We abstracted data for 2,336 women with a mean age of 26±5.9 years. At least one NCD was present in 6.4% (n=149) including anemia (n= 77, 3.3%), chronic hypertension (n=35, 1.5%), pre-gestational diabetes (n=16, 0.7%), asthma (n=9, 0.4%) and cardiac disease (n=6, 0.3%). Overall, 542 (23.2%) women had obstetric complications, including pre-eclampsia (n=265, 11.3%); preterm labor (n=67, 2.9%); placental abruption (n=29, 1.2%); PPH (n=54, 2.3%); and gestational diabetes (n=5, 0.2%). Women with NCDs had increased likelihood of having an obstetric complication compared to women without (overall proportion 33.6% vs 22.5% respectively; adjusted prevalence ratio (aPR): overall, 1.8, 95% CI: 1.4-2.3; pre-eclampsia (1.8, 95%CI: 1.2-2.8), gestational diabetes (12.0, 95%CI: 2.0-72.7), deep venous thrombosis (6.0, 95%CI: 1.3-27.1), placenta abruption (4.4, 95%CI: 1.5-12.6) and postpartum hemorrhage (4.3, 95%CI: 2.2-8.3).

Conclusion: We found that NCDs were associated with a nearly two-fold increased risk of obstetric complications. Our findings highlight the need for further research to understand the impact of this risk, particularly on maternal and fetal outcomes. Additionally, these findings suggest strengthened NCD surveillance, as means to increased preparedness, and management for potential obstetric complications among pregnant women in Uganda.