Ernawati, Ernawati and Akbar, Muhammad I. A. and Aryananda, Rozi Aditya and Bachnas, Muhammad A. and Irwinda, Rima and Dewantiningrum, Julian and Bernolian, Nuswil and Dekker, Gustaaf and Dachlan, Erry Gumilar and Mose, Johanes C and Wibowo, Noroyono and Sulistyowati, Sri and Lumbanraja, Sarma and Wantania, John J.E. and Yusrawati and Chalid, Maisuri T and Yeni, Cut Meurah and Serudji, Joserizal and Kusuma, Anak Agung Ngurah Jaya and Wiradyana, Anak Agung Gede Putra and Anggraini, Nutria Widya Purna and Kaeng, Junneke J and Defrin and Santoso, Dhanny Primatara Johari and Banjarnahor, Dharma Putra P and Pramono, Besari Adi and Pudyastuti, Sri and Lisnawati, Yuyun and Danianto, Ario and Resistantie, Novi and Aziz, Aryani and Suratman, A.I. and Sriyanti, Roza and Hafiz, Alini and Satriadi, Tedy Teguh and Putri, Ruth Widhiati Raharjo and Djuanda, Jonathan Kevin and Ditya B, Ariawan and Darus, Febriansyah and Prasetyadi, Fransiscus Octavianus Hari and Hamid, Agus Rusdhy Hariawan and Aditiawarman and Rahardjo, Bambang and Sulistyono, Agus and Wardhana, Manggala Pasca Wardhana and Aziz, Muhammad Alamsyah and Pribadi, Adhi and Gumilar, Khanizyah Erza (2025) HELLP syndrome as a major contributor to adverse maternal and neonatal outcomes among preeclamptic women: findings from a multicenter retrospective cohort study. BMC Pregnancy and Childbirth, 25 (1).

Text (Artikel Ilmiah) 1. HELLP syndrome as a major contributor to adverse maternal and neonatal outcomes among preeclamptic women findings from a multicenter retrospective cohort study.pdf Restricted to Registered users only Download (1MB) | Request a copy

Abstract

Objective: HELLP syndrome, a severe complication of preeclampsia, is associated with increased maternal and neonatal morbidity and mortality. This study aims to evaluate maternal and perinatal outcomes in preeclamptic women with and without HELLP syndrome in Indonesia. Methods: A multicenter retrospective cohort study was conducted across 30 hospitals in Indonesia from January 2022 to December 2023. Data from 1,808 preeclamptic women were analyzed, with 219 (12.1%) classified as having HELLP syndrome. Maternal and perinatal outcomes were compared between the HELLP and non-HELLP groups. Results: Women with HELLP syndrome had significantly higher risks of severe complications, including eclampsia (p < 0.001; aOR: 2.5 (1.5–4.18)), acute kidney injury (p < 0.01; aOR: 4.11 (2.07–8.15)), emergency hypertension (p = 0.048; aOR: 1.42 (1.01–2.01)), preterm birth < 37 weeks (p = 0.013; aOR: 1.54 (1.1–2.17)), and preterm birth < 34 weeks (p < 0.001; aOR: 1.8 (1.28–2.53)). HELLP syndrome increased the risk of Intra-uterine fetal death (p = 0.01; aOR: 2.18 (1.21–3.95)) and neonatal sepsis (p = 0.011; aOR: 2.32 (1.21–4.42)). Although the multivariate analysis did not yield any significant results, the HELLP syndrome group has a substantially higher prevalence of maternal death (3.7% vs 1%; p = 0.005) and neonatal death (11.6% vs 6.4%; p = 0.005). Conclusion: HELLP syndrome significantly worsens maternal and neonatal outcomes in preeclampsia, reflecting a need for improved early detection of ‘high-risk’ preeclamptic women like sFlt1/PLGF ratio and perhaps other laboratory tests like haptoglobin and D-dimer’s. Many of these laboratory tests are currently not accessible in the Indonesian public health sector. Further research is needed to identify other markers that would assist in a more timely diagnosis of impending HELLP syndrome, particularly in early-onset preeclampsia patients managed conservatively.

Actions (login required)

View Item