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*Since preeclampsia and eclampsia are one of the main causes of maternal deaths, the data on incidence is required at both national and local levels to inform policies to further target the affected population and for the focused distribution of resources. | *Since preeclampsia and eclampsia are one of the main causes of maternal deaths, the data on incidence is required at both national and local levels to inform policies to further target the affected population and for the focused distribution of resources. | ||
*A systematic review conducted for the incidence of hypertensive disorders of pregnancy (HDP) with the objective of evaluating its magnitude globally, representing 39 million women from 40 countries, estimates the incidence to be 4.6% (95% uncertainty range 2.7-8.2), and 1.4% (95% uncertainty range 1.0-2.0) of all deliveries for preeclampsia and eclampsia respectively, with a wide variation across regions.<ref name="pmid23746796">{{cite journal| author=Abalos E, Cuesta C, Grosso AL, Chou D, Say L| title=Global and regional estimates of preeclampsia and eclampsia: a systematic review. | journal=Eur J Obstet Gynecol Reprod Biol | year= 2013 | volume= 170 | issue= 1 | pages= 1-7 | pmid=23746796 | doi=10.1016/j.ejogrb.2013.05.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23746796 }} </ref> | *A systematic review conducted for the incidence of hypertensive disorders of pregnancy (HDP) with the objective of evaluating its magnitude globally, representing 39 million women from 40 countries, estimates the incidence to be 4.6% (95% uncertainty range 2.7-8.2), and 1.4% (95% uncertainty range 1.0-2.0) of all deliveries for preeclampsia and eclampsia respectively, with a wide variation across regions.<ref name="pmid23746796">{{cite journal| author=Abalos E, Cuesta C, Grosso AL, Chou D, Say L| title=Global and regional estimates of preeclampsia and eclampsia: a systematic review. | journal=Eur J Obstet Gynecol Reprod Biol | year= 2013 | volume= 170 | issue= 1 | pages= 1-7 | pmid=23746796 | doi=10.1016/j.ejogrb.2013.05.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23746796 }} </ref> | ||
*The incidence of hypertensive disorders of pregnancy increased from 16.30 million to 18.08 million worldwide, with a total increase of 10.92% from 1990 to 2019.<ref>Wei Wang, Xin Xie, Ting Yuan et al. Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study, 18 January 2021, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-146936/v1]</ref> | |||
*The age-standardized incidence rate decreased, with an estimated annual percentage change of -0.68 (95% CI -0.49 to -0.86). Age-standardized incidence rates were higher in countries/regions with lower sociodemographic indices and human development indices.<ref>Wei Wang, Xin Xie, Ting Yuan et al. Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study, 18 January 2021, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-146936/v1]</ref> | |||
*The estimated incidence rate was lowest in the group aged 25-29 years and higher in the youngest and oldest groups.<ref>Wei Wang, Xin Xie, Ting Yuan et al. Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study, 18 January 2021, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-146936/v1]</ref> | |||
*Positive associations between incidence and sociodemographic index and human development index were found for all countries and regions in 2019.<ref>Wei Wang, Xin Xie, Ting Yuan et al. Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study, 18 January 2021, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-146936/v1]</ref> | |||
===Prevalance=== | ===Prevalance=== | ||
*The prevalence of eclampsia was reported to be 0.56 per 1,000 births (from US data from 1979-86) and 26 per 1,000 births for pre-eclampsia.<ref>{{cite journal |journal= Am J Obstet Gynecol. 1990 Aug;163(2): 460-5. | title=Epidemiology of preeclampsia and eclampsia in the United States, 1979-1986. |author=Saftlas AF, Olson DR, Franks AL, Atrash HK, Pokras R. |pmid=2396132}}</ref> | |||
*While mortality can be kept low when antenatal care and [[maternal-fetal medicine| maternal-fetal services]] are provided, mortality rates are substantial in challenging settings. In a setting in India, [[maternal mortality]] and [[perinatal mortality]] were reported to be 32% and 39%, respectively, in the year 1993.<ref> {{cite journal |author= Swain S, Ojha KN, Prakash A, Bhatia BD.| title=Maternal and perinatal mortality due to eclampsia. |journal=Indian Pediatr. 1993 Jun;30(6):771-3}}</ref> | |||
===Impact=== | ===Impact=== | ||
*Total deaths attributable to pregnancy-related causes are over half a million and 99% of these deaths come from low- to middle-income nations. | *Total deaths attributable to pregnancy-related causes are over half a million and 99% of these deaths come from low- to middle-income nations. | ||
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*Perinatal mortality is high following preeclampsia, and even higher following eclampsia. | *Perinatal mortality is high following preeclampsia, and even higher following eclampsia. | ||
*The Millennium Development Goals have placed maternal health at the core of the struggle against poverty and inequality, as a matter of human rights. | *The Millennium Development Goals have placed maternal health at the core of the struggle against poverty and inequality, as a matter of human rights. | ||
* | *The number of deaths attributed to hypertensive disorders of pregnancy was approximately 27.83 thousand in 2019 which was a 30.05% decrease from the year 1990. <ref>Wei Wang, Xin Xie, Ting Yuan et al. Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study, 18 January 2021, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-146936/v1]</ref> | ||
==References== | ==References== | ||
Revision as of 09:44, 12 August 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [6]
Overview
Hypertensive disorders of pregnancy (HDP), defined as a sex-specific cardiovascular disease, is one of the leading causes of maternal and fetal morbidity and mortality globally and a critical threat to maternal and infant health. [1][7]
Epidemiology and Demographics of Eclampsia
Incidence
- Since preeclampsia and eclampsia are one of the main causes of maternal deaths, the data on incidence is required at both national and local levels to inform policies to further target the affected population and for the focused distribution of resources.
- A systematic review conducted for the incidence of hypertensive disorders of pregnancy (HDP) with the objective of evaluating its magnitude globally, representing 39 million women from 40 countries, estimates the incidence to be 4.6% (95% uncertainty range 2.7-8.2), and 1.4% (95% uncertainty range 1.0-2.0) of all deliveries for preeclampsia and eclampsia respectively, with a wide variation across regions.[2]
- The incidence of hypertensive disorders of pregnancy increased from 16.30 million to 18.08 million worldwide, with a total increase of 10.92% from 1990 to 2019.[3]
- The age-standardized incidence rate decreased, with an estimated annual percentage change of -0.68 (95% CI -0.49 to -0.86). Age-standardized incidence rates were higher in countries/regions with lower sociodemographic indices and human development indices.[4]
- The estimated incidence rate was lowest in the group aged 25-29 years and higher in the youngest and oldest groups.[5]
- Positive associations between incidence and sociodemographic index and human development index were found for all countries and regions in 2019.[6]
Prevalance
- The prevalence of eclampsia was reported to be 0.56 per 1,000 births (from US data from 1979-86) and 26 per 1,000 births for pre-eclampsia.[7]
- While mortality can be kept low when antenatal care and maternal-fetal services are provided, mortality rates are substantial in challenging settings. In a setting in India, maternal mortality and perinatal mortality were reported to be 32% and 39%, respectively, in the year 1993.[8]
Impact
- Total deaths attributable to pregnancy-related causes are over half a million and 99% of these deaths come from low- to middle-income nations.
- High blood pressure during pregnancy is seen in ten percent of women and preeclampsia complicates 2% to 8% of pregnancies which can include problems in the liver, kidneys, brain and the clotting system and risks for the baby include poor growth and prematurity.[9]
- Although preeclampsia can be devastating and life-threatening the outcome is often good and manageable.
- Overall, 10% to 15% of direct maternal deaths are associated with preeclampsia and eclampsia and most of these deaths are attributable to eclampsia, rather than preeclampsia.[9]
- Perinatal mortality is high following preeclampsia, and even higher following eclampsia.
- The Millennium Development Goals have placed maternal health at the core of the struggle against poverty and inequality, as a matter of human rights.
- The number of deaths attributed to hypertensive disorders of pregnancy was approximately 27.83 thousand in 2019 which was a 30.05% decrease from the year 1990. [10]
References
- ↑ Garovic V, White W, Vaughan L, Saiki M, Parashuram S, Garcia-Valencia O,et al. Incidence and long-term outcomes of hypertensive disorders of pregnancy. J Am Coll Cardiol. 2020;75(18):2323–34
- ↑ Abalos E, Cuesta C, Grosso AL, Chou D, Say L (2013). "Global and regional estimates of preeclampsia and eclampsia: a systematic review". Eur J Obstet Gynecol Reprod Biol. 170 (1): 1–7. doi:10.1016/j.ejogrb.2013.05.005. PMID 23746796.
- ↑ Wei Wang, Xin Xie, Ting Yuan et al. Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study, 18 January 2021, PREPRINT (Version 1) available at Research Square [1]
- ↑ Wei Wang, Xin Xie, Ting Yuan et al. Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study, 18 January 2021, PREPRINT (Version 1) available at Research Square [2]
- ↑ Wei Wang, Xin Xie, Ting Yuan et al. Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study, 18 January 2021, PREPRINT (Version 1) available at Research Square [3]
- ↑ Wei Wang, Xin Xie, Ting Yuan et al. Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study, 18 January 2021, PREPRINT (Version 1) available at Research Square [4]
- ↑ Saftlas AF, Olson DR, Franks AL, Atrash HK, Pokras R. "Epidemiology of preeclampsia and eclampsia in the United States, 1979-1986". Am J Obstet Gynecol. 1990 Aug;163(2): 460-5. PMID 2396132.
- ↑ Swain S, Ojha KN, Prakash A, Bhatia BD. "Maternal and perinatal mortality due to eclampsia". Indian Pediatr. 1993 Jun;30(6):771-3.
- ↑ 9.0 9.1 Duley L (2009). "The global impact of pre-eclampsia and eclampsia". Semin Perinatol. 33 (3): 130–7. doi:10.1053/j.semperi.2009.02.010. PMID 19464502.
- ↑ Wei Wang, Xin Xie, Ting Yuan et al. Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study, 18 January 2021, PREPRINT (Version 1) available at Research Square [5]