Eclampsia in Australia and New Zealand: A prospective population-based study.

Pollock, W; Peek, MJ; Wang, A; Li, Z; Ellwood, D; Homer, CSE; Jackson Pulver, L; McLintock, C; Vaughan, G; Knight, M; Sullivan, EA

Eclampsia in Australia and New Zealand: A prospective population-based study.

Pollock, W Peek, MJ Wang, A Li, Z

Ellwood, D Homer, CSE Jackson Pulver, L McLintock, C Vaughan, G

Knight, M Sullivan, EA

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Australian and New Zealand Journal of Obstetrics and Gynaecology, 2020, 60, (4), pp. 533-540
Issue Date:: 2020-08

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Field	Value	Language
dc.contributor.author	Pollock, W
dc.contributor.author	Peek, MJ
dc.contributor.author	Wang, A
dc.contributor.author	Li, Z https://orcid.org/0000-0002-7622-150X
dc.contributor.author	Ellwood, D
dc.contributor.author	Homer, CSE
dc.contributor.author	Jackson Pulver, L
dc.contributor.author	McLintock, C
dc.contributor.author	Vaughan, G https://orcid.org/0000-0002-0132-9946
dc.contributor.author	Knight, M
dc.contributor.author	Sullivan, EA
dc.date.accessioned	2021-04-23T00:43:06Z
dc.date.available	2019-10-10
dc.date.available	2021-04-23T00:43:06Z
dc.date.issued	2020-08
dc.identifier.citation	Australian and New Zealand Journal of Obstetrics and Gynaecology, 2020, 60, (4), pp. 533-540
dc.identifier.issn	0004-8666
dc.identifier.issn	1479-828X
dc.identifier.uri	http://hdl.handle.net/10453/148289
dc.description.abstract	BACKGROUND:Eclampsia is a serious consequence of pre-eclampsia. There are limited data from Australia and New Zealand (ANZ) on eclampsia. AIM:To determine the incidence, management and perinatal outcomes of women with eclampsia in ANZ. MATERIALS AND METHODS:A two-year population-based descriptive study, using the Australasian Maternity Outcomes Surveillance System (AMOSS), carried out in 263 sites in Australia, and all 24 New Zealand maternity units, during a staggered implementation over 2010-2011. Eclampsia was defined as one or more seizures during pregnancy or postpartum (up to 14 days) in any woman with clinical evidence of pre-eclampsia. RESULTS:Of 136 women with eclampsia, 111 (83%) were in Australia and 25 (17%) in New Zealand. The estimated incidence of eclampsia was 2.2 (95% confidence interval (CI) 1.9-2.7) per 10 000 women giving birth. Aboriginal and Torres Strait Islander women were over-represented in Australia (n = 9; 8.1%). Women with antepartum eclampsia (n = 58, 42.6%) were more likely to have a preterm birth (P = 0.04). Sixty-three (47.4%) women had pre-eclampsia diagnosed prior to their first eclamptic seizure of whom 19 (30.2%) received magnesium sulphate prior to the first seizure. Nearly all women (n = 128; 95.5%) received magnesium sulphate post-seizure. No woman received prophylactic aspirin during pregnancy. Five women had a cerebrovascular haemorrhage, and there were five known perinatal deaths. CONCLUSIONS:Eclampsia is an uncommon consequence of pre-eclampsia in ANZ. There is scope to reduce the incidence of this condition, associated with often catastrophic morbidity, through the use of low-dose aspirin and magnesium sulphate in women at higher risk.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation	http://purl.org/au-research/grants/nhmrc/510298
dc.relation.ispartof	Australian and New Zealand Journal of Obstetrics and Gynaecology
dc.relation.isbasedon	10.1111/ajo.13100
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.mesh	Humans
dc.subject.mesh	Eclampsia
dc.subject.mesh	Premature Birth
dc.subject.mesh	Magnesium Sulfate
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Pregnancy
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Australia
dc.subject.mesh	New Zealand
dc.subject.mesh	Female
dc.subject.mesh	Australia
dc.subject.mesh	Eclampsia
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Magnesium Sulfate
dc.subject.mesh	New Zealand
dc.subject.mesh	Pregnancy
dc.subject.mesh	Premature Birth
dc.subject.mesh	Prospective Studies
dc.title	Eclampsia in Australia and New Zealand: A prospective population-based study.
dc.type	Journal Article
utslib.citation.volume	60
utslib.location.activity	Australia
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	closed_access	*
pubs.consider-herdc	true
dc.date.updated	2021-04-23T00:43:03Z
pubs.issue	4
pubs.publication-status	Published
pubs.volume	60
utslib.citation.issue	4

Abstract:

BACKGROUND:Eclampsia is a serious consequence of pre-eclampsia. There are limited data from Australia and New Zealand (ANZ) on eclampsia. AIM:To determine the incidence, management and perinatal outcomes of women with eclampsia in ANZ. MATERIALS AND METHODS:A two-year population-based descriptive study, using the Australasian Maternity Outcomes Surveillance System (AMOSS), carried out in 263 sites in Australia, and all 24 New Zealand maternity units, during a staggered implementation over 2010-2011. Eclampsia was defined as one or more seizures during pregnancy or postpartum (up to 14 days) in any woman with clinical evidence of pre-eclampsia. RESULTS:Of 136 women with eclampsia, 111 (83%) were in Australia and 25 (17%) in New Zealand. The estimated incidence of eclampsia was 2.2 (95% confidence interval (CI) 1.9-2.7) per 10 000 women giving birth. Aboriginal and Torres Strait Islander women were over-represented in Australia (n = 9; 8.1%). Women with antepartum eclampsia (n = 58, 42.6%) were more likely to have a preterm birth (P = 0.04). Sixty-three (47.4%) women had pre-eclampsia diagnosed prior to their first eclamptic seizure of whom 19 (30.2%) received magnesium sulphate prior to the first seizure. Nearly all women (n = 128; 95.5%) received magnesium sulphate post-seizure. No woman received prophylactic aspirin during pregnancy. Five women had a cerebrovascular haemorrhage, and there were five known perinatal deaths. CONCLUSIONS:Eclampsia is an uncommon consequence of pre-eclampsia in ANZ. There is scope to reduce the incidence of this condition, associated with often catastrophic morbidity, through the use of low-dose aspirin and magnesium sulphate in women at higher risk.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/148289