Incidence and natural history of preeclampsia/eclampsia at the university maternity of Antananarivo, Madagascar: high prevalence of the early-onset condition.

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  • Additional Information
    • Source:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 101136916 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-4954 (Electronic) Linking ISSN: 14764954 NLM ISO Abbreviation: J Matern Fetal Neonatal Med Subsets: MEDLINE
    • Publication Information:
      Publication: London : Informa Healthcare
      Original Publication: Boca Raton : Parthenon Pub. Group, c2002-
    • Subject Terms:
      Eclampsia/*epidemiology ; Pre-Eclampsia/*epidemiology ; Pregnancy Outcome/*epidemiology; Academic Medical Centers ; Adult ; Age of Onset ; Eclampsia/pathology ; Female ; Fetal Mortality ; Gestational Age ; Humans ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn ; Madagascar/epidemiology ; Maternal Health Services ; Maternal Mortality ; Pre-Eclampsia/pathology ; Pregnancy ; Prevalence ; Young Adult
    • Abstract:
      Objectives: To investigate the incidence of early - (delivery <34 weeks) (EOP) versus late-onset (delivery ≥34 weeks) (LOP) in Madagascar. Study design: Eight months observational study of all preeclamptic/eclamptic women delivering at the maternity of the University Hospital of Befelatanana, Antananarivo, Madagascar. Sociodemographical and obstetrical risk factors are analyzed. Results: Over the study period, we found 142 combined preeclampsia/eclampsia among 4316 births (incidence 3.3% for singleton pregnancies), of which 65 eclampsia (1.5% of all deliveries). The rate of delivery <34 weeks of gestation in preeclamptic women was 37.3% and 38.5% in eclamptic ones. The overall rate of fetal and neonatal mortality was of 50% (71/142). In EO forms the infant death rate was 83% (44/53), of which approximately 33% were due to intrauterine fetal death. In LO forms, the infant death rate was 20% in preeclampsia (15% of fetal deaths), while in case of maternal eclamptic seizures the infant mortality rate was doubled (40%). There were seven maternal deaths (of which four were eclamptic women). Conclusions: We have in Madagascar a high rate of early-onset preeclampsia/eclampsia EOP (37% versus approximately 10% in international literature) and a consequent worrying rate of maternal-fetal mortality. We could find other high incidence of EOP in nine other geographical locations: Guadeloupe (31%), Réunion (31%), Mauritius (34%), Cameroon (37.4%), China (38%), Zimbabwe (58%), Thailand (34%), Turkey (29%), and India (26%). Emerging and tropical countries may belong to the "high rate of EOP standard." There is an urgent need to have additional data from these areas to confirm the hypothesis.
    • Contributed Indexing:
      Keywords: Preeclampsia; developing countries; early-onset preeclampsia; epidemiology
    • Publication Date:
      Date Created: 20180407 Date Completed: 20200120 Latest Revision: 20200120
    • Publication Date:
      20221213
    • Accession Number:
      10.1080/14767058.2018.1462323
    • Accession Number:
      29621911