Pre‐eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health

Abstract

Objective To 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.Design Secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health (WHOMCS) database.Setting Cross-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.Population All women suffering from any hypertensive disorder during pregnancy, the intrapartum or early postpartum period in the participating hospitals during the study period.Methods We 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 measures Hypertensive disorders of pregnancy.Potentially life-threatening conditions among maternal near-miss cases, maternal deaths and cases without severe maternal outcomes.Results Overall, 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.Conclusions The 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.

Geographical Distribution of Hypertensive Disorders in Pregnancy and their Adverse Maternal and Perinatal Outcomes in Thailand

“…The incidence of hypertensive disorders in pregnancy in our study (27.5 per 1000 deliveries) was similar to the finding of secondary analysis of the World Health Organization Multicounty Survey on Maternal and Newborn Health from 29 countries in Africa, Asia, Latin America and the Middle East (27.3 per 1000 deliveries) and showed various geographic distribution [6]. A previous study conducted in central of Thailand reported the prevalence of preeclampsia accounted for 47 per 1000 deliveries [7].…”

“…A previous study conducted in central of Thailand reported the prevalence of preeclampsia accounted for 47 per 1000 deliveries [7]. The different reports on the incidence of hypertensive subgroups was mainly because the different classifications were chosen [5][6][7]. Maternal age at ≥35 years were consistently reported to be the concurrent risk of hypertensive disorders in pregnancy [5,8,9].…”

Neonatal near miss and mortality: factors associated with life-threatening conditions in newborns at six public maternity hospitals in Southeast Brazil

“…Regarding hemorrhage and high blood pressure, studies have reported an increased risk of perinatal death 25,26 , prematurity, low birth weight, and asphyxia at birth 15 among infants of mothers with hypertension in pregnancy, still a common condition during pregnancy 27,28 , and of mothers with vaginal hemorrhage prior to labor 17,29 .…”

Efficacy of structured teaching programme on home care management of pregnancy induced hypertension in primigravida mothers: a tertiary hospital study

“…WHO multi country survey reveals incidence of gestational hypertension (4.4%), preeclampsia (3%), eclampsia (0.8%) and chronic hypertension (0.1%) in India. 1 While hospital incidence of hypertensive disease of pregnancy is 7.8% in Bharati Hospital and Research Centre.…”