Abstract
Objectives: To evaluate prevalence and predictors of eclampsia in patients with preeclampsia. Material and Methods: database of 11,026 consecutive births attended between Nov-98 and Jun-04, 323 patients admitted with a diagnosis of preeclampsia (blood pressure >=140-90 in 2 doses plus proteinuria) were included in this retrospective analysis. Eclampsia was diagnosed in the presence of associated seizures. Multiple logistic regression analysis was performed to identify independent markers of eclampsia. Results: The diagnosis of eclampsia was established in 32 (10%) patients. Patients with and without eclampsia differed in the following characteristics: primiparous (14.7 vs 6.4%, p=0.014), chronic anemia (14.6 vs 7.2%, p=0.031), adolescence (≤ 16 years) (40 vs 8.4%, p =0.002), smoking (29.2 vs 8.4%, p=0.005), multiple pregnancy (47.1 vs 8%, p<0.0001) and obesity (2.1 vs 11.8%, p=0.026). In the multivariate analysis, the independent predictors were the followings: multiple pregnancy (OR=13.6, 95%CI=4.4-41.8, p<0.0001), smoking (OR=4.9, 95%CI=1.6-15.1, p=0.006) and adolescence (OR =17.9, 95%CI=4.7-67.7, p<0.0001). In patients with none, one or two, and three variables, eclampsia occurred in 0% (0 of 265 cases), 44.7% (24 of 47), and 100% (11 of 11), respectively (p<0.0001). Conclusions: One in 10 patients with preeclampsia developed eclampsia during hospitalization. Three simple and widely available variables (adolescent mothers, smokers, and twin pregnancy) were useful to identify low- and high-risk population.