Bridging the gaps in knowledge, attitudes and practices on pre-eclampsia: key insights for improving maternal and neonatal healthcare in developing countries

Abstract

Pre-eclampsia, a devastating obstetrical complication of pregnancy, poses significant risks to both maternal and fetal health. This condition is estimated to affect 2%-15% of all pregnancies globally. Despite considerable attention, the exact aetiology of pre-eclampsia is still debatable; however, it is increasingly recognised as a placental disorder with lasting implications for both mother and child, potentially predisposing them to chronic diseases later in life. This review highlights the urgent need for targeted interventions and policy development to improve maternal health outcomes. It further reviews the latest advancements in prediction, prevention, management and the knowledge among healthcare workers, pregnant women and the community in general. Through the lens of Tanzania's healthcare landscape, where challenges are compounded by scarce healthcare resources and limited awareness, the review calls for a comprehensive approach to enhance management of pre-eclampsia. Recommendations include targeted screening measures, such as first trimester assessments of uterine artery blood flow resistance due to impaired spiral artery remodelling, use of diagnostic biomarkers, lifestyle modifications including weight control, a healthy diet and regular exercise, advanced practical training for primary healthcare providers, improved antenatal care facilities and strengthened education on pre-eclampsia for pregnant women to support early diagnosis and intervention. With a call for innovation in diagnostic methods and a deeper dive into the disease's underlying mechanisms, the review aims to advance clinical practice and reduce both maternal and fetal morbidity and mortality associated with this prevalent obstetrical complication.

Contributors AM and JFL contributed to the writing, drafting and reviewing the manuscript. PBM supervised the work, edited and revised the manuscript. All authors read and approved the final version of the manuscript. AM is the guarantor and takes full responsibility for the content of this manuscript.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

Patient consent for publication Not applicable.

Ethics approval Not applicable.

Provenance and peer review Not commissioned; externally peer reviewed.

Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See https://creativecommons.org/licenses/by-nc/4.0/.

ORCID iD

Alex Madimo https://orcid.org/0009-0003-3639-3950

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