FALLING POPULATION INCIDENCE OF ECLAMPSIA - A CASE-CONTROL STUDY OF SHORT-TERM OUTCOME

Background, Eclampsia remains a serious complication of pregnancy and childbirth and factors related to morbidity require continued evaluation. Design. Retrospective case-control study on the incidence and outcome of eclampsia. Setting. A defined total island population over 20 years. Methods. All centrally collected birth registration returns in Iceland for the years 1972-1991 were reviewed to identify women with the diagnosis of eclampsia, selecting women delivering immediately before and after the eclamptic case as controls. Information from all places where women had delivered was obtained to ensure that no case was missed. Maternity records were reviewed to verify the diagnosis and obtain maternal and neonatal data. Results. Forty women had eclampsia (0.046% of deliveries). Theincidence diminished between the decades 1972-81 and 1982-91 (p < 0.05), as did the incidence of eclamptic convulsions before delivery. Eclamptic women were more often primiparous, younger and delivered earlier than controls. Preterm delivery and a low ponderal index were more common among offspring of the eclamptic mothers and the male/female ratio was lower. Conclusion. The incidence of eclampsia in the population is falling. Common features related to the condition were confirmed. Severe maternal illness is rare, but the babies often appear growth-retarded and are delivered preterm.