title: Clinical morbidities, trends, and demographics of eclampsia: a population-based study.
abstract: OBJECTIVE
  We sought to identify trends, demographics, and prepregnancy and peripartum morbidities of eclampsia in California.
  
  
  METHODS
  We identified cases of eclampsia by International Classification of Diseases, Ninth Revision code using California health discharge data from 2001 through 2007. Cases with missing race/ethnicity as well as age <15 years or >55 years were excluded. Among the remaining cases, patients with eclampsia (n = 1888) were compared against those without (n = 2,768,983). Adjustments were performed for potential confounding variables using logistic regression. Significance was set at P < .05.
  
  
  RESULTS
  The incidence of eclampsia decreased over time, from 8.0 cases per 10,000 deliveries in 2001, to 5.6 cases per 10,000 deliveries in 2007 (P < .001). There was a bimodal distribution in age-related risk, with the highest risks at the extremes of age. Non-Hispanic blacks were associated with the highest risk of eclampsia while Asians had the lowest risk. Several antepartum morbidities had increased associations with eclampsia, including preexisting cardiac disease (adjusted odds ratio [OR], 6.84; 95% confidence interval [CI], 5.40-8.66), lupus erythematosus (adjusted OR, 3.68; 95% CI, 1.53-8.86), and twin gestations (adjusted OR, 3.28; 95% CI, 2.70-3.99). Peripartum complications increased in eclampsia included cerebrovascular hemorrhage/disorders (adjusted OR, 112.15; 95% CI, 77.47-162.35), peripartum cardiomyopathy (adjusted OR, 12.88; 95% CI, 6.08-27.25), amniotic fluid embolism (adjusted OR, 11.94; 95% CI, 3.63-39.21), and venous thromboembolism (adjusted OR, 10.71; 95% CI, 5.14-22.32).
  
  
  CONCLUSIONS
  This large population database confirms that there is a decline in eclampsia over time. However, there are extremely morbid complications associated with eclampsia, emphasizing the need for its close monitoring and prevention.
authors.affiliation: Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Fong
authors.forename: Cindy Tung
authors.initials: CT
authors.lastname: Chau
authors.forename: Deyu
authors.initials: D
authors.lastname: Pan
authors.forename: Dotun Adeboye
authors.initials: DA
authors.lastname: Ogunyemi
mesh_terms: D000293:Adolescent; D000328:Adult; D004461:Eclampsia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009017:Morbidity; D011247:Pregnancy; D012189:Retrospective Studies; D012306:Risk
keywords: demographics; eclampsia; morbidities; trends