The Global Impact of Pre-eclampsia and Eclampsia
Section snippets
Maternal Health is a Human Right
More than 30 years ago, the high maternal mortality in low- and middle-income countries was highlighted as a “neglected tragedy.”3 Although the risk of maternal death has reduced in some of these countries over the intervening years, little has improved for many with the highest mortality. Nevertheless, most maternal deaths are potentially avoidable. Most could be prevented by access to appropriate maternity services and to emergency obstetric care, and many of the root causes are related to
Pre-eclampsia and Eclampsia
Hypertension is common during pregnancy. Approximately 10% of women will have their blood pressure recorded as above normal at some point before delivery. Pre-eclampsia, defined as hypertension accompanied by proteinuria,9 usually occurs during the second half of pregnancy and complicates 2%-8% of pregnancies.10 For women who have mild to moderate hypertension alone, pregnancy outcome is similar to that for women with normal blood pressure. Once proteinuria develops, or blood pressure becomes
Mortality and Morbidity for Women
Eclampsia is rare in Europe, with 2 to 3 cases reported per 10,000 births.11, 12 In developing countries, eclampsia is more common, with the incidence estimated as 16-69 cases per 10,000 births.13 Although rare, eclampsia accounts for more than 50,000 maternal deaths each year.14 Overall, 10%-15% of direct maternal deaths are associated with pre-eclampsia and eclampsia in low- and middle-income countries.14, 15 Ninety-nine percent of maternal deaths occur in low- and middle-income countries.1
Mortality and Morbidity for Infants
Pre-eclampsia can affect blood supply to the placenta, leading to poor intrauterine growth, and can precipitate preterm birth. Therefore, risks for the infant are also increased. Pre-eclampsia is an antecedent for up to 12% of infants born small for gestational age35 and one-fifth of those born preterm.36 Perinatal mortality is high after pre-eclampsia,18, 37 and even higher after eclampsia.13, 27, 38 One-quarter of stillbirths and neonatal deaths in developing countries are associated with
Long-term Sequelae for Women and Children
Whether pre-eclampsia and eclampsia have long-term implications for the health and well-being of the women remains uncertain. Nevertheless, there is growing evidence that women who have had gestational hypertension or pre-eclampsia are at increased risk later in life for hypertension, stroke, and ischemic heart disease.46, 47, 48 What is less clear is whether this reflects a common pathway, or whether having pre-eclampsia increases this risk.49
There are also long-term consequences for the
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