Incidence of eclampsia in Japanese women

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Aim: The aim of this study was to assess the rate of eclampsia in Japanese women and to determine differences in the pathogenesis of eclampsia between women with pregnancy induced hypertension (PIH) but without severe proteinuria showing rapid changes in high blood pressure during delivery and women with PIH and severe proteinuria from early stages of pregnancy.Methods: We used the perinatal database of the Japan Society of Obstetrics and Gynecology to access 330,399 deliveries after 22 weeks of gestation across 125 centers of the perinatal network between 2005 and 2009. A total of 246 women with eclampsia were identified. The main outcome measures used were incidence, maternal age, body mass index (BMI), parity, gestational age at delivery, and mortality rate. We compared gestational age at incidence between women with PIH but without severe proteinuria (HT group) and women with PIH and severe proteinuria (PE group). Data were analyzed using Welch’s t-test or the Mann-Whitney U-test.Results: We identified a total of 246 cases of eclampsia which corresponded to an incidence of 7.4/10,000 deliveries with a mean age of onset of 30.7±5.8 years. The proportion of primiparous women was 81.3%, and the mean gestational age at delivery was 36.7±4.0 weeks. Four maternal deaths were identified in the PE group. The gestational age at incidence was significantly higher in the HT group compared to the PE group (36.8±4.9 weeks for the HT group vs. 34.3±4.9 weeks for the PE group, t=3.3443, P=0.0009).Conclusions: The present study identified potential differences in the pathogenesis of eclampsia between HT and PE groups, due to the fact that the PE group was observed throughout pregnancy, while observation of individuals in the HT group increased after 34 weeks of gestation.

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