Using data from the Nationwide Readmissions Database covering the years 2010 to 2018, the researchers evaluated over 27.4 million delivery hospitalizations across the United States. Out of these, 20,478 deliveries were complicated by eclampsia, translating to a rate of about 74.7 per 100,000.
The analysis revealed the following findings:
- Women with eclampsia had a cardiovascular readmission rate of 854 per 100,000 within one year of delivery.
- In comparison, normotensive women had a significantly lower readmission rate of 147 per 100,000.
- This resulted in an adjusted hazard ratio (HR) of 6.9, indicating a strong association between eclampsia and increased CVD risk.
- Stroke posed the highest risk among all cardiovascular complications, with an adjusted HR of 12.6.
- Other cardiovascular conditions also showed elevated risks, with adjusted HRs ranging from 4.8 to 15.5.
- The increased risk of cardiovascular events was noticeable as early as the first month after childbirth.
- These findings highlight the need for immediate and targeted cardiovascular follow-up in women who experience eclampsia during pregnancy.
The research team also performed quantitative bias analyses to account for potential misclassification of eclampsia and other unmeasured confounders, reinforcing the robustness of their findings.
These results build on existing evidence linking hypertensive pregnancy disorders to long-term cardiovascular complications, but they go a step further by highlighting that the danger begins much earlier than previously assumed.
The authors advocate for structured short-term cardiovascular follow-up for women with eclampsia, noting that early detection and intervention could be key in reducing life-threatening complications in the postpartum period. As maternal health remains a global priority, the findings point to a critical gap in postnatal care that must be addressed urgently.
"These findings highlight the urgent need for enhanced short-term monitoring and early detection of cardiovascular disease in women who experience eclampsia," the authors concluded.
Reference:
Fields, J. C., Rosenfeld, E. B., Lee, R., Brandt, J. S., Graham, H. L., Rosen, T., & Ananth, C. V. Eclampsia and early readmission for cardiovascular disease. European Heart Journal. https://doi.org/10.1093/eurheartj/ehaf389
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