Abstract
Pre-eclampsia-Eclampsia (PE-E) is a multisystem disorder of uncertainty etiology. In Sub-Saharan Africa, it is still one of the leading causes of maternal death, morbidity, and long-term disability. The status of maternal hypocalcemia has been implicated in the pathogenesis of PE-E. However, there are controversial findings from previous studies done to assess the association between maternal hypocalcemia with PE-E. This contradiction causes inconsistency in checking up on maternal hypocalcemia in routine antenatal care. We conducted a 1:2 matched case control study to determine the association of total maternal hypocalcemia with PE-E among pregnant women attending at Bugando Medical Centre, a tertiary referral hospital in Mwanza, Northwestern Tanzania. This study involved 127 cases and 254 controls. The matching variables were gestational age (± 1 week) and maternal age (± 1 year). Cubital venous blood was collected for measuring total serum calcium levels among cases and controls. Data were collected using a standardized, pre-tested, and coded questionnaire, then entered into a computer using Microsoft Excel 2013, and analyzed using STATA version 15. Conditional logistic regression analysis adjusted for body mass index (BMI) and referral status was used to determine the association between total maternal hypocalcemia and PE-E. The p-value of less than 0.05 considered statistically significant. A total 381 pregnant women, 127 cases matched with 254 controls, were involved into this study Overall, the median age was 29 [IQR 26-33] years and 28.1% (107/381) were primigravidae. Total maternal hypocalcemia was significantly associated with PE-E (un-adjusted OR 8.6; 95% CI 4.7-15.7; p-value < 0.001 and adjusted OR 11.2; 95% CI 5.5-22.8; p-value < 0.001). Our study found a strong association of total hypocalcemia with PE-E. We emphasize the need for routine screening for maternal hypocalcemia during antenatal clinic visits. We recommend routine calcium supplementation for pregnant women, especially those at risk for PE-E.