Bellizzi Saverio, Sobel Howard L, Ali Mohamed M
UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
World Health Organization, Western Pacific Regional Office, Manila, Philippines.
Int J Gynaecol Obstet. 2017 Oct;139(1):50-54. doi: 10.1002/ijgo.12262. Epub 2017 Jul 30.
To determine the prevalence of eclampsia symptoms and to explore associations between eclampsia and early neonatal mortality.
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.
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).
Increased risk of early neonatal mortality indicates a need for strategies targeting the early detection of eclampsia and early interventions.
确定子痫症状的患病率，并探讨子痫与早期新生儿死亡率之间的关联。
本次二次分析纳入了2005年至2012年的人口与健康调查数据；包括受访者在前5年最近一次分娩期间单胎分娩严重产科不良事件相关体征的详细信息。将数据与分娩史合并进行汇总分析。比较了用作子痫经历指标的惊厥和早期新生儿死亡率，并使用针对国家间和国家内异质性进行调整的广义随机效应模型来研究推定子痫对早期新生儿死亡率的影响。
合并数据集包括来自哥伦比亚、孟加拉国、印度尼西亚、马里、尼日尔和秘鲁的六项调查中的55384例活产数据。美洲、东南亚和非洲地区报告的分娩中，分别有1.2%（95%置信区间[CI]1.0 - 1.3）、1.7%（95%CI 1.5 - 2.1）和1.7%（95%CI 1.5 - 2.1）记录有子痫迹象。汇总分析表明，子痫与早期新生儿死亡风险增加相关（调整风险比2.1，95%CI 1.4 - 3.2）。
早期新生儿死亡风险增加表明需要制定针对子痫早期检测和早期干预的策略。
