Evaluation of the Education and Counseling Program on Pregnant Women With Risk of Preeclampsia: A Prospective Randomized Controlled Trial

Preeclampsia affects 3% to 5% of pregnancies, and is a pregnancy-specific syndrome; it leads to maternal, fetal and neonatal morbidity and mortality worldwide especially in developing countries. If not treated, pregnant woman may have many serious complications, such as pulmonary edema, eclampsia, stroke, placental abruption, and acute renal diseases . Babies born to mothers with preeclampsia have an increased risk of low Apgar scores, neonatal encephalopathy, seizures, neonatal intensive care admission, and neonatal deaths caused by preterm birth and low gestational age. Preeclampsia also affects the health-related quality of life negatively.

Since the etiology and pathogenesis of preeclampsia is unclear, it is very important to investigate the risk factors of preeclampsia to identify the pregnant women in the risk group, and to ensure more intensive care, observation and follow-ups. The known risk factors for preeclampsia include primiparity, advanced maternal age, family history of preeclampsia, previous preeclamptic pregnancy, autoimmune diseases, hypertension, history of thrombophilia, diabetes, in vitro fertilization, multifetal pregnancy, type I diabetes mellitus or type II diabetes mellitus and obesity..

It is known that the population has difficulty understanding even basic information related to health, and especially preeclampsia. Increasing the preeclampsia knowledge of women will help them to recognize early symptoms, and negative signs of preeclampsia, and may lead them to seek earlier individual care. Also, it is estimated that appropriate patient education and counseling for preeclampsia may prevent half of the most serious consequences related to maternal symptoms. This estimation is supported by a study, that women diagnosed with preeclampsia receiving proper and timely follow-up had fewer adverse events than those with delayed diagnosis. Preeclampsia education and counseling subjects may include recommendations for increasing awareness (preeclampsia signs and signs of danger, follow-up at home) and lifestyle modifications (physical activity, coping with stress, nutrition advices) to contribute to the prevention preeclampsia risks.

Although many studies have been carried out on medical treatment and improved outcomes in women with preeclampsia, there are limited studies about the consequences of education and counseling of pregnant women with risk of preeclampsia. Therefore, the objective of this study was to evaluate the effects of maternal and neonatal consequences of an education and counseling program on at-risk pregnant women.

Trial Design and Participants This study was a single-center, single-blinded, prospective randomized controlled trial (RCT), parallel-group RCT comparing the effects of a preeclampsia education and counseling program during pregnancy with standard antenatal care. Participants were 132 pregnant women with risk of preeclampsia.