Factors Influencing Gestational Hypertension and Preeclampsia of Parturients During the First Stage of Labor
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Abstract
Purpose: To determine the predictive powers of age, pre-pregnancy BMI, anxiety during labor, and intimate partner violence on gestational hypertension and preeclampsia of parturients during the first stage of labor.
Design: Case-control study.
Methods: The sample consisted of 195 postpartum mothers who had normal and operative delivery for at least 24 hours from a tertiary hospital in Bangkok. Total participants were divided into 2 groups: the 65 cases were diagnosed with gestational hypertension and preeclampsia during the first stage of labor and the 130 controls had normal blood pressure during the first stage of labor. Data were collected by using the Personal Data Questionnaire, the Obstetric Records, the Anxiety during Labor Questionnaires, and the Abuse Assessment Screen, respectively. Data were analyzed by using descriptive statistics, chi-square tests, and multiple logistic regression analysis.
Main findings: The results indicated that age, pre-pregnancy BMI, anxiety during labor and intimate partner violence could significantly explain 36% (R2 = .36) of the variance in gestational hypertension and preeclampsia among partutients during the first stage of labor and had a prediction accuracy of 76.9% (overall percentage = 76.9). The predictive factors included anxiety during labor (OR = 6.83, 95%CI = 3.10, 15.05), pre-pregnancy BMI which included obesity (OR = 5.73, 95%CI = 2.27, 14.46) and overweight (OR = 3.29, 95%CI = 1.39, 7.80), and intimate partner violence (OR = 2.92, 95%CI = 1.27, 6.70), respectively.
Conclusion and recommendations: Anxiety during labor, pre-pregnancy BMI, and intimate partner violence affected GHT and PE in the first stage of labor. Therefore, midwives should screen those risk factors and develop a care model for parturients to prevent GHT and PE during the first stage of labor.
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