Epidemiological Risk Factor Analysis for Maternal Mortality Associated with Eclampsia: A Single-Center Study from Tertiary Hospital Garut

Background: Maternal mortality remains a major global health challenge, particularly in low- and middle-income countries. Eclampsia, a severe complication of hypertensive disorders in pregnancy, continues to contribute substantially to maternal and perinatal deaths despite advances in obstetric care. Previous studies have highlighted the role of clinical and laboratory abnormalities in worsening outcomes; however, evidence from developing settings remains limited. A clearer understanding of maternal mortality risk factors in eclampsia is essential to improve early detection, risk stratification, and clinical management. Objective: To identify maternal mortality risk factors associated with eclampsia based on patient characteristics, clinical presentation, and laboratory findings. Methods: A retrospective observational study was conducted using medical records of pregnant women diagnosed with eclampsia between January 2022 and March 2024 at a tertiary referral hospital. Demographic data, clinical features, and laboratory parameters were extracted systematically. Statistical analysis included univariate and bivariate analyses using the Chi-square test to assess associations between variables and maternal mortality. Multivariate logistic regression analysis was performed to determine independent risk factors and estimate odds ratios (OR) with corresponding p-values. Statistical significance was set at p ≤ 0.05. Results: A total of 112 patients met the inclusion criteria. The eclampsia case fatality rate was 20.54%. Laboratory parameters demonstrated significant associations with maternal mortality. Severe proteinuria (+3) was associated with increased mortality risk (OR = 1.67; p = 0.05). Anemia, defined as hematocrit < 35%, showed a strong association with maternal death (OR = 2.25; p = 0.001). Additionally, HELLP syndrome significantly increased the risk of maternal mortality (OR = 2.82). Conclusion: Laboratory abnormalities are key predictors of maternal mortality in eclampsia. Severe proteinuria, anemia, and HELLP syndrome should be promptly identified and managed to reduce adverse maternal outcomes. Keywords: epidemiology, case fatality rate, eclampsia, risk factors