Across four Thai tertiary hospitals, a case-control study compared 156 postpartum women with preeclampsia: 52 with and 104 without severe features, alongside data from 111 nurse-midwives. After adjustment for antenatal visits and gravidity, prior preeclampsia was associated with 5.99-fold higher odds of severe features. Moderate knowledge and higher BMI showed inverse associations, which should not be treated as causal protection.
Key findings
- Prior preeclampsia was associated with severe features (aOR 5.99, 95% CI 2.13–16.83).
- Moderate versus low knowledge had an aOR of 0.13 (95% CI 0.04–0.50), while BMI had an aOR of 0.92 per kg/m².
- The model explained 29.4% of variance and correctly classified 75.8%; infant birth weight was lower with severe features, while asphyxia and NICU admission did not differ significantly.
Why this matters globally
Prior preeclampsia can help prioritise closer surveillance, and the knowledge association supports antenatal education as part of care. Prospective multilevel validation is required before using these variables as a prediction tool.
Thai researcher contribution
Tippawan Boonyaporn, Piyanun Limruangrong, Ameporn Ratinthorn and Thitipong Tankumpuan of Mahidol University examined maternal and service factors directly in Thai tertiary hospitals.
Limitations to consider
The retrospective case-control design is vulnerable to recall and selection bias. Only 52 severe cases were included, some CIs were wide, and service-level null results may reflect limited power. Inverse BMI and knowledge associations do not prove protection.