Community perceptions of pre-eclampsia and eclampsia in Ogun State, Nigeria: a qualitative study
OBJECTIVE To explore traditional herbal medicines as potential risk factors of severe preeclampsia and eclampsia in Nigeria. METHODS We conducted a retrospective case-control study from October 2010 to May 2011. The cases were all pregnant women admitted to the Jahun Hospital during the study period with severe preeclampsia or eclampsia and women presenting with normal pregnancy after 22 weeks. RESULTS During the study period, a total of 1,257 women (44%) were recorded as having normal pregnancy, and 419 (16%) women had severe preeclampsia/eclampsia (175 with severe preeclampsia and 244 with eclampsia). The risk factors found to be associated with a greater risk of severe preeclampsia/eclampsia included personal history of preeclampsia (odds ratio [OR] = 21.5; P < 0.001), personal history of preexisting hypertension (OR = 10.5; P < 0.001), primiparity (OR = 2.5; P = 0.001), occupation as housewife (OR = 1.9; P = 0.008), and fewer than four antenatal care visits (OR = 1.6; P = 0.02). Use of traditional treatments during pregnancy was associated with a higher risk of developing severe preeclampsia/eclampsia (OR = 1.6 95%; confidence interval [CI]: 1.2-2.1) by univariate analysis only. CONCLUSION Use of traditional treatment, which increases delays before consulting the official health sector, might be a marker for harmful behavior. Community-based studies could provide additional information on the practice of herbal therapy in this population.