Pre‐eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health
Adult
Asia
Adolescent
Maternal-Child Health Centers
Gestational Age
Middle East
03 medical and health sciences
0302 clinical medicine
Pre-Eclampsia
Infant Mortality
Humans
Eclampsia
Policy Making
2. Zero hunger
Severe maternal outcomes
Incidence
Infant, Newborn
16. Peace & justice
3. Good health
Parity
Cross-Sectional Studies
Latin America
Maternal Mortality
Risk factors
Near miss
Health Care Surveys
Africa
Practice Guidelines as Topic
Female
Pre-eclampsia
DOI:
10.1111/1471-0528.12629
Publication Date:
2014-03-18T11:53:38Z
AUTHORS (8)
ABSTRACT
ObjectiveTo assess the incidence of hypertensive disorders of pregnancy and related severe complications, identify other associated factors and compare maternal and perinatal outcomes in women with and without these conditions.DesignSecondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health (WHOMCS) database.SettingCross‐sectional study implemented at 357 health facilities conducting 1000 or more deliveries annually in 29 countries from Africa, Asia, Latin America and the Middle East.PopulationAll women suffering from any hypertensive disorder during pregnancy, the intrapartum or early postpartum period in the participating hospitals during the study period.MethodsWe calculated the proportion of the pre‐specified outcomes in the study population and their distribution according to hypertensive disorders' severity. We estimated the association between them and maternal deaths, near‐miss cases, and severe maternal complications using a multilevel logit model.Main outcome measuresHypertensive disorders of pregnancy. Potentially life‐threatening conditions among maternal near‐miss cases, maternal deaths and cases without severe maternal outcomes.ResultsOverall, 8542 (2.73%) women suffered from hypertensive disorders. Incidences of pre‐eclampsia, eclampsia and chronic hypertension were 2.16%, 0.28% and 0.29%, respectively. Maternal near‐miss cases were eight times more frequent in women with pre‐eclampsia, and increased to up to 60 times more frequent in women with eclampsia, when compared with women without these conditions.ConclusionsThe analysis of this large database provides estimates of the global distribution of the incidence of hypertensive disorders of pregnancy. The information on the most frequent complications related to pre‐eclampsia and eclampsia could be of interest to inform policies for health systems organisation.
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