Prevalence of and risk factors for eclampsia in pregnant women in India

Objective: Eclampsia is a potentially fatal disorder in pregnant women and remains an important cause of maternal and perinatal child morbidity and death worldwide. We aimed to assess the prevalence of and risk factors for convulsions (not occurring from fever) during pregnancy in Indian women. Convulsion is a key symptom suggestive of eclampsia.

Methods: Cross-sectional data from India’s third National Family Health Survey, conducted during 2005‐2006 were used. Self-reported information on convulsions during pregnancy was ­obtained from 39,657 women aged 15‐49 years who had a live birth in the 5 years preceding the survey. Multiple logistic regression analysis was used to explore risk factors for convulsion in­ pregnancy.

Results: Overall, 1 in 10 women reported having convulsions in their most recent pregnancy. The prevalence was significantly higher in women living in rural areas compared with those living in urban areas (11.3% vs. 7.4%; P<0.0001), with marked state and geographic variation. The odds of convulsions were significantly higher in women with a twin pregnancy [odds ratio (OR) 2.12; 95% confidence interval (CI) 1.45‐3.11], a previously terminated pregnancy (OR 1.32; 95% CI 1.20‐1.45), diabetes (OR 1.37; 95% CI 0.99‐1.89), or asthma (OR 1.85; 95% CI 1.35‐2.54), in women who were alerted to pregnancy complications (OR 2.78; 95% CI 2.50‐3.08), in Sikh women (OR 1.73; 95% CI 1.28‐2.33), in women in a low social group (OR 1.40; 95% CI 1.25‐1.58), and in women residing in central India (OR 1.51; 95% CI 1.31‐1.74) or eastern India (OR 1.33; 95% CI 1.14‐1.54) with reference to their counterparts.

Conclusion: Our findings from a large population-based nationally representative sample of Indian women indicate a high prevalence of convulsions, a symptom suggestive of eclampsia, and its association with several maternal, lifestyle risk factors and sociodemographic characteristics.