Factors Associated with Adverse Fetal Outcomes in Severe Preeclampsia Complicated by Acute Kidney Injury: An Observational Study at Bogodogo University Hospital, Burkina Faso

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Résumé

Introduction: Acute kidney injury (AKI) during severe preeclampsia represents
a major public health problem. It is associated with high perinatal morbidity and
mortality. Several factors, when present, may influence perinatal outcomes. The
objective of this study was to describe the factors associated with adverse fetal
outcomes in acute kidney injury during severe preeclampsia. Methods: The
study was conducted in Burkina Faso at the University Hospital Center of Bogodogo.
It was a descriptive-analytical study carried out from September 1, 2023,
to August 31, 2024. Exhaustive sampling was used. Univariate analysis was performed
using the Chi-square test, followed by multivariate logistic regression to
identify factors associated with adverse fetal outcomes. A significance level of
<5% was considered. Results: A total of 72 cases of AKI during severe preeclampsia
were collected. The age group of 18 - 34 years was the most represented. Regarding
adverse fetal outcomes, 27 perinatal deaths were recorded, representing
37.5%. Gestational age below 35 weeks significantly increased the risk of perinatal
death by more than 19-fold (adjusted OR = 19.5; 95% CI: 3.81 - 40.12; P =
0.001). A systolic blood pressure between 160 and 180 mmHg reduced the risk
of perinatal death by 88% (adjusted OR = 0.12; 95% CI: 0.01 - 0.80). Conclusion:
This study highlights the high frequency of adverse perinatal outcomes in
preeclampsia complicated by acute kidney injury. Prematurity was significantly
associated with perinatal death, whereas a systolic blood pressure between 160
and 180 mmHg appeared to be a protective factor.

Mots-clés

Fetal Outcome, Preeclampsia, Acute Kidney Injury