Knowledge, Lifestyle Factors, and Antenatal Care Utilization in Relation to Clinician-recorded Preeclampsia among Pregnant Women Attending Selected General Hospitals in Nasarawa State, Nigeria: A Cross-sectional Study

Introduction: Preeclampsia remains a major contributor to maternal and perinatal morbidity and mortality, particularly in low- and middle-income settings. Although antenatal care (ANC), lifestyle modification, and maternal knowledge are central to prevention and early detection, their associations with clinical diagnosis and pregnancy outcomes remain unclear. This study assessed the relationships between maternal knowledge, attitudes, lifestyle behaviours, family and medical history, ANC utilisation, and clinical indicators with preeclampsia diagnosis and pregnancy outcomes among pregnant women. Methodology: A facility-based cross-sectional study was conducted among 423 pregnant women attending ANC services. Data were collected using a structured questionnaire and clinical records. Variables assessed included knowledge, attitudes, and practices related to preeclampsia; ANC attendance; lifestyle behaviours (smoking, alcohol use, physical activity, and diet); family and medical history; and clinical indicators such as blood pressure and urine protein. Associations were examined using chi-square tests, with statistical significance set at p < 0.05. Results: Out of 423 women, 85.3% had good knowledge of preeclampsia and 52.0% had neutral attitudes. Family history of preeclampsia was not significantly associated with a history of miscarriage, stillbirth, or previous preeclampsia/eclampsia (p > 0.05). BP and urine protein, abstracted from the most recent record, were not statistically associated with clinician-recorded preeclampsia in this cross-sectional analysis. Smoking and alcohol use were not associated with clinician-recorded preeclampsia. They were associated with a history of chronic hypertension before pregnancy, based on very few participants (n = 8). Fruit and vegetable intake frequency was associated with a history of miscarriage (p = 0.049), based on eight events; this should be interpreted cautiously. ANC visit frequency and knowledge of preeclampsia were not statistically associated with clinician-recorded preeclampsia. Conclusion: Despite high maternal knowledge, awareness and routine clinical indicators alone were not associated with preeclampsia diagnosis or pregnancy outcomes. These findings highlight the need for comprehensive, risk-based antenatal screening and integrated preventive strategies addressing underlying chronic conditions.