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Signs of eclampsia during singleton deliveries and early neonatal mortality in low‐ and middle‐income countries from three WHO regions
Author(s) -
Bellizzi Saverio,
Sobel Howard L.,
Ali Mohamed M.
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12262
Subject(s) - medicine , eclampsia , confidence interval , singleton , obstetrics , neonatal mortality , pregnancy , pediatrics , demography , infant mortality , population , environmental health , genetics , sociology , biology
Objective To determine the prevalence of eclampsia symptoms and to explore associations between eclampsia and early neonatal mortality. Methods The present secondary analysis included Demographic and Health Surveys data from 2005 to 2012; details of signs related to severe obstetric adverse events of singleton deliveries during interviewees’ most recent delivery in the preceding 5 years were included. Data and delivery history were merged for pooled analyses. Convulsions—used as an indicator for having experienced eclampsia—and early neonatal mortality rates were compared, and a generalized random effect model, adjusted for heterogeneity between and within countries, was used to investigate the impact of presumed eclampsia on early neonatal mortality. Results The merged dataset included data from six surveys and 55 384 live deliveries that occurred in Colombia, Bangladesh, Indonesia, Mali, Niger, and Peru. Indications of eclampsia were recorded for 1.2% (95% confidence interval [CI] 1.0–1.3), 1.7% (95% CI 1.5–2.1), and 1.7% (95% CI 1.5–2.1) of deliveries reported from the American, South East Asian, and African regions, respectively. Pooled analyses demonstrated that eclampsia was associated with increased risk of early neonatal mortality (adjusted risk ratio 2.1 95% CI 1.4–3.2). Conclusion Increased risk of early neonatal mortality indicates a need for strategies targeting the early detection of eclampsia and early interventions.