Researchers in Ethiopia studied 270 pregnant women to understand what causes preeclampsia, a serious pregnancy condition that affects blood pressure. They found that women who were overweight before pregnancy, had high blood pressure in their family, were carrying twins or multiples, or had high blood pressure during mid-pregnancy were more likely to develop preeclampsia. The good news? Taking iron and folic acid supplements during pregnancy appeared to lower the risk. This research helps doctors identify which pregnant women need extra monitoring and care.

The Quick Take

  • What they studied: What factors make pregnant women more likely to develop preeclampsia, a dangerous condition where blood pressure gets too high during pregnancy?
  • Who participated: 270 pregnant and laboring women at a hospital in Ethiopia. About one-third had preeclampsia (the cases), and two-thirds did not (the controls used for comparison).
  • Key finding: Women who were overweight before getting pregnant were nearly 7 times more likely to develop preeclampsia. Women with high blood pressure in their family were 3 times more likely. Women carrying twins or multiples were 5 times more likely. Women with high blood pressure in the middle of pregnancy were 7.5 times more likely.
  • What it means for you: If you’re planning to get pregnant, maintaining a healthy weight beforehand may help reduce your risk. If you have a family history of high blood pressure or are carrying multiples, your doctor should monitor you more closely. Taking iron and folic acid supplements as recommended appears protective. However, this study was done in one hospital in Ethiopia, so results may differ in other populations.

The Research Details

This was a case-control study, which is like comparing two groups of people to find differences. Researchers looked at women who had already developed preeclampsia (the ‘cases’) and compared them to women who didn’t develop it (the ‘controls’). By looking backward at what was different about these two groups before the condition developed, researchers could identify risk factors.

The study included 270 women total—90 with preeclampsia and 180 without. Researchers collected information about their weight before pregnancy, family health history, whether they were carrying multiples, their blood pressure during pregnancy, and their nutrition habits. They then used statistical tests to figure out which factors were most strongly connected to preeclampsia.

This type of study is useful for identifying risk factors quickly and efficiently, though it can’t prove that one thing directly causes another.

Understanding what increases preeclampsia risk is critical because this condition can be life-threatening for both mother and baby if not caught early. In developing countries like Ethiopia, many women don’t have access to regular prenatal care, so identifying high-risk women helps doctors focus their limited resources on those who need it most. This research provides practical information that local healthcare providers can use to improve maternal care.

The study was published in BMC Pregnancy and Childbirth, a reputable medical journal. Researchers used appropriate statistical methods to analyze their data. However, the study was conducted at a single hospital in one region of Ethiopia, so the results may not apply equally to all populations. The study design (case-control) is good for identifying risk factors but cannot prove cause-and-effect relationships. Readers should note that some findings, like coffee drinking being protective, were unexpected and need confirmation in future research.

What the Results Show

The strongest risk factors for preeclampsia were: (1) High blood pressure in the middle of pregnancy (diastolic pressure of 80 mmHg or higher), which increased risk 7.6 times; (2) Being overweight before pregnancy, which increased risk 6.7 times; (3) Carrying twins or multiples, which increased risk 5.4 times; and (4) Having a family member with high blood pressure, which increased risk 3.1 times.

These findings suggest that a woman’s health before pregnancy and her genetics play important roles in preeclampsia risk. The fact that blood pressure in mid-pregnancy was the strongest predictor makes sense because preeclampsia is fundamentally a blood pressure disorder.

The study also identified two protective factors—things that lowered risk. Women who took iron and folic acid supplements during pregnancy had about half the risk of preeclampsia compared to those who didn’t take supplements. Interestingly, women who drank coffee during pregnancy also had lower risk, though researchers noted this finding was unexpected and needs more study.

The research confirmed that multiple pregnancies (twins, triplets) significantly increase preeclampsia risk, which aligns with what doctors already know. The protective effect of iron and folic acid supplementation is particularly important because these are inexpensive, widely available supplements that could be promoted in developing countries. The coffee finding was surprising and contradicts some previous research, suggesting more investigation is needed before drawing conclusions.

The findings about overweight status, family history of hypertension, and multiple pregnancies align with existing medical knowledge about preeclampsia risk factors. The protective effect of iron and folic acid supplementation supports previous research suggesting nutritional status matters for pregnancy health. However, the coffee finding is unusual and inconsistent with some other studies, indicating this needs further research to understand if it’s a real effect or a coincidence in this particular study.

This study was conducted at only one hospital in Ethiopia, so results may not apply to all pregnant women worldwide or even throughout Ethiopia. The study design (case-control) looks backward at what happened, which can introduce bias—women with preeclampsia might remember or report their health habits differently than women without it. The study didn’t control for all possible factors that might affect preeclampsia risk. The sample size, while reasonable, was relatively small. The unexpected finding about coffee needs confirmation before being considered reliable. Researchers didn’t have detailed information about all potential risk factors.

The Bottom Line

Women planning pregnancy should aim for a healthy weight beforehand (moderate confidence—supported by this study and others). Pregnant women, especially those with risk factors, should attend regular prenatal appointments and have blood pressure monitored (high confidence—standard medical practice). All pregnant women should take iron and folic acid supplements as recommended by their healthcare provider (moderate-to-high confidence—supported by this study and general prenatal guidelines). Women with family history of high blood pressure or carrying multiples should inform their doctor for closer monitoring (moderate confidence—based on this research). The coffee finding is too preliminary to make recommendations about.

Women planning to become pregnant should care about this research, especially those who are overweight or have family history of high blood pressure. Pregnant women, particularly those with identified risk factors, should use this information to understand why their doctor recommends certain monitoring. Healthcare providers in developing countries should use these findings to identify high-risk women who need extra attention. This research is less directly relevant to women in countries with excellent prenatal care systems, though the basic risk factors apply universally.

Changes from maintaining a healthy weight before pregnancy could take months to years to show benefit. Iron and folic acid supplementation should be started before pregnancy or as soon as pregnancy is confirmed, with benefits potentially appearing throughout pregnancy. Blood pressure monitoring should happen at every prenatal visit, with concerning changes detected within days to weeks. Prevention of preeclampsia through these measures is an ongoing process throughout pregnancy, not something with a quick timeline.

Want to Apply This Research?

  • Track blood pressure at each prenatal visit and log it in the app with the date. Set up alerts if readings reach 140/90 mmHg or higher, which should prompt contacting a healthcare provider. Include a note about whether iron and folic acid supplements were taken that day.
  • Use the app to set a daily reminder to take iron and folic acid supplements at the same time each day. Create a checklist for prenatal appointments to ensure blood pressure is checked. If planning pregnancy, use the app to track weight loss progress if overweight, with a goal of reaching a healthy BMI before conception.
  • Throughout pregnancy, log blood pressure readings at each prenatal visit and track any patterns. Monitor supplement adherence daily. For women with risk factors (family history of hypertension, overweight status, or multiple pregnancy), use the app to flag these in their profile so they remember to discuss extra monitoring with their healthcare provider. Create a trend report monthly to share with their doctor.

This research describes risk factors for preeclampsia identified in one hospital in Ethiopia and may not apply equally to all populations. Preeclampsia is a serious medical condition that requires professional medical care. This information is for educational purposes only and should not replace consultation with a healthcare provider. Pregnant women or those planning pregnancy should discuss their individual risk factors with their doctor and follow their healthcare provider’s recommendations for monitoring and treatment. If you experience symptoms of preeclampsia such as severe headache, vision changes, upper abdominal pain, or sudden swelling, seek immediate medical attention.