Key result
Among 2,955 eclampsia cases, 45.8% occurred during a postpartum readmission, with 95% of these readmissions occurring within the first 2 weeks after discharge.
Why the study?
The contemporary prevalence of eclampsia in the United States and whether it takes place during the delivery hospitalization or a postpartum readmission were uncharacterized.
Cohort (n=1,590,563)
Yes
Almost half of eclampsia cases occur after discharge from the delivery admission, predominantly within the first two weeks, highlighting the need for targeted postpartum prevention strategies.
Answers are grounded in this paper and cite their sources.
Supports enhanced postpartum monitoring in first 2 weeks; leaves open whether targeted strategies reduce eclampsia incidence.
Objective To characterize the contemporary prevalence of eclampsia in the United States and determine whether eclampsia is taking place during the delivery hospitalization or a postpartum readmission.Study design We conducted a retrospective cohort using the 2016 Nationwide Readmission Database, a discharge database of all hospitalizations in 27 states in the U.S. Through the database, we identified women with an admission for delivery of a neonate > 20 weeks gestation. We also identified readmissions that occurred within 6 weeks after discharge from that delivery admission. ICD-10-CM codes were used to identify deliveries, eclampsia and co-morbidities. The primary outcome was timing of eclampsia relative to discharge from the delivery admission.Results We identified 1,590,563 deliveries of which 2955 (0.19%) were complicated by eclampsia during the delivery admission or a postpartum readmission. Of these cases of eclampsia, 1575 (53.5%) occurred during the delivery admission, 1354 (45.8%) during a postpartum readmission and 26 (0.88%) during both the delivery and a postpartum readmission. Of the 1380 readmissions with eclampsia, 1117 (81%) occurred within the first week after delivery discharge. Another 194 (14%) occurred in the second week after discharge. Women with readmissions for eclampsia were older (30.1 vs. 28.8 years; p < .01), delivered earlier (37.7 vs. 38.5 weeks; p < .01), and more likely to have a cesarean delivery (48.4 vs. 32.4%; p < .01) or multiple gestation (4.0 vs. 1.8%; p < .01) as compared to those not readmitted for eclampsia and 44% had any hypertensive disorder during the delivery admission (vs. 12.2% without an eclampsia readmission; p < .01).Conclusion Of the 2955 cases of eclampsia identified, almost half of them occurred after discharge from the delivery admission, 95% of which occurred within the first 2 weeks after discharge, demonstrating the prominence of postpartum eclampsia which may warrant new strategies for prevention and education targeted at postpartum patients after delivery hospitalization.
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Yoselevsky et al. (2022) conducted a cohort in Eclampsia (n=1,590,563). Delivery of a neonate > 20 weeks gestation was evaluated on Timing of eclampsia relative to discharge from the delivery admission. Among 2,955 eclampsia cases, 45.8% occurred during a postpartum readmission, with 95% of these readmissions occurring within the first 2 weeks after discharge.
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