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

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.
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http://hal.univ-reunion.fr/hal-02015107
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Submitted on : Tuesday, February 12, 2019 - 6:16:19 AM
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Andriamanetsiarivo Tanjona Ratsiatosika, Eric Razafimanantsoa, Valéry Bruno Andriantoky, Noël Ravoavison, Rakotovao Andrianampanalinarivo Hery, et al.. Incidence and natural history of preeclampsia/eclampsia at the university maternity of Antananarivo, Madagascar: high prevalence of the early-onset condition. Journal of Maternal-Fetal and Neonatal Medicine, Taylor & Francis, 2018, pp.1-6. ⟨10.1080/14767058.2018.1462323⟩. ⟨hal-02015107⟩

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