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

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.