The burden of eclampsia: results from a multicenter study on surveillance of severe maternal morbidity in Brazil.

<h4>Objective</h4>Maternal mortality (MM) is a core indicator of disparities in women's rights. The study of Near Miss cases is strategic to identifying the breakdowns in obstetrical care. In absolute numbers, both MM and occurrence of eclampsia are rare events. We aim to assess the...

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Autores principales:	Juliana C Giordano, Mary A Parpinelli, Jose G Cecatti, Samira M Haddad, Maria L Costa, Fernanda G Surita, Joao L Pinto E Silva, Maria H Sousa
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/10d1183c6b12463cb9bedeeec897c1b5
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spelling	oai:doaj.org-article:10d1183c6b12463cb9bedeeec897c1b52021-11-18T08:19:28ZThe burden of eclampsia: results from a multicenter study on surveillance of severe maternal morbidity in Brazil.1932-620310.1371/journal.pone.0097401https://doaj.org/article/10d1183c6b12463cb9bedeeec897c1b52014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24825164/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Maternal mortality (MM) is a core indicator of disparities in women's rights. The study of Near Miss cases is strategic to identifying the breakdowns in obstetrical care. In absolute numbers, both MM and occurrence of eclampsia are rare events. We aim to assess the obstetric care indicators and main predictors for severe maternal outcome from eclampsia (SMO: maternal death plus maternal near miss).<h4>Methods</h4>Secondary analysis of a multicenter, cross-sectional study, including 27 centers from all geographic regions of Brazil, from 2009 to 2010. 426 cases of eclampsia were identified and classified according to the outcomes: SMO and non-SMO. We classified facilities as coming from low- and high-income regions and calculated the WHO's obstetric health indicators. SPSS and Stata softwares were used to calculate the prevalence ratios (PR) and respective 95% confidence interval (CI) to assess maternal characteristics, clinical and obstetrical history, and access to health services as predictors for SMO, subsequently correlating them with the corresponding perinatal outcomes, also applying multiple regression analysis (adjusted for cluster effect).<h4>Results</h4>Prevalence of and mortality indexes for eclampsia in higher and lower income regions were 0.2%/0.8% and 8.1%/22%, respectively. Difficulties in access to health care showed that ICU admission (adjPR 3.61; 95% CI 1.77-7.35) and inadequate monitoring (adjPR 2.31; 95% CI 1.48-3.59) were associated with SMO.<h4>Conclusions</h4>Morbidity and mortality associated with eclampsia were high in Brazil, especially in lower income regions. Promoting quality maternal health care and improving the availability of obstetric emergency care are essential actions to relieve the burden of eclampsia.Juliana C GiordanoMary A ParpinelliJose G CecattiSamira M HaddadMaria L CostaFernanda G SuritaJoao L Pinto E SilvaMaria H SousaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 5, p e97401 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Juliana C Giordano Mary A Parpinelli Jose G Cecatti Samira M Haddad Maria L Costa Fernanda G Surita Joao L Pinto E Silva Maria H Sousa The burden of eclampsia: results from a multicenter study on surveillance of severe maternal morbidity in Brazil.
description	<h4>Objective</h4>Maternal mortality (MM) is a core indicator of disparities in women's rights. The study of Near Miss cases is strategic to identifying the breakdowns in obstetrical care. In absolute numbers, both MM and occurrence of eclampsia are rare events. We aim to assess the obstetric care indicators and main predictors for severe maternal outcome from eclampsia (SMO: maternal death plus maternal near miss).<h4>Methods</h4>Secondary analysis of a multicenter, cross-sectional study, including 27 centers from all geographic regions of Brazil, from 2009 to 2010. 426 cases of eclampsia were identified and classified according to the outcomes: SMO and non-SMO. We classified facilities as coming from low- and high-income regions and calculated the WHO's obstetric health indicators. SPSS and Stata softwares were used to calculate the prevalence ratios (PR) and respective 95% confidence interval (CI) to assess maternal characteristics, clinical and obstetrical history, and access to health services as predictors for SMO, subsequently correlating them with the corresponding perinatal outcomes, also applying multiple regression analysis (adjusted for cluster effect).<h4>Results</h4>Prevalence of and mortality indexes for eclampsia in higher and lower income regions were 0.2%/0.8% and 8.1%/22%, respectively. Difficulties in access to health care showed that ICU admission (adjPR 3.61; 95% CI 1.77-7.35) and inadequate monitoring (adjPR 2.31; 95% CI 1.48-3.59) were associated with SMO.<h4>Conclusions</h4>Morbidity and mortality associated with eclampsia were high in Brazil, especially in lower income regions. Promoting quality maternal health care and improving the availability of obstetric emergency care are essential actions to relieve the burden of eclampsia.
format	article
author	Juliana C Giordano Mary A Parpinelli Jose G Cecatti Samira M Haddad Maria L Costa Fernanda G Surita Joao L Pinto E Silva Maria H Sousa
author_facet	Juliana C Giordano Mary A Parpinelli Jose G Cecatti Samira M Haddad Maria L Costa Fernanda G Surita Joao L Pinto E Silva Maria H Sousa
author_sort	Juliana C Giordano
title	The burden of eclampsia: results from a multicenter study on surveillance of severe maternal morbidity in Brazil.
title_short	The burden of eclampsia: results from a multicenter study on surveillance of severe maternal morbidity in Brazil.
title_full	The burden of eclampsia: results from a multicenter study on surveillance of severe maternal morbidity in Brazil.
title_fullStr	The burden of eclampsia: results from a multicenter study on surveillance of severe maternal morbidity in Brazil.
title_full_unstemmed	The burden of eclampsia: results from a multicenter study on surveillance of severe maternal morbidity in Brazil.
title_sort	burden of eclampsia: results from a multicenter study on surveillance of severe maternal morbidity in brazil.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/10d1183c6b12463cb9bedeeec897c1b5
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The burden of eclampsia: results from a multicenter study on surveillance of severe maternal morbidity in Brazil.

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