{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:58:44Z","timestamp":1781153924017,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the incidence of eclampsia, characterise maternal and perinatal profiles, and document outcomes across seven countries within the International Obstetric Survey System and identify inter\u2010country differences that may improve maternal and perinatal care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multi\u2010country analysis of population\u2010based cohort data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Six high\u2010income countries (Belgium, France, Italy, the Netherlands, Norway, Slovakia) and one upper\u2010middle\u2010income country (Suriname).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>All women admitted with eclampsia in participating countries between 2012 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individual participant data meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Incidence of eclampsia, maternal demographics, pregnancy characteristics, clinical management, mode of delivery and maternal and perinatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>615 cases of eclampsia were notified resulting in a pooled incidence of eclampsia of 2.2 per 10,000 deliveries in high\u2010income countries and 36.6 per 10,000 deliveries in Suriname. About 42% of women were diagnosed with preeclampsia before seizure onset and one\u2010third experienced their first seizure postpartum. Hypertension was the most reported clinical sign (91.1%). Most women were treated with magnesium sulphate (91.1%) and antihypertensive medications (89.8%). Caesarean section was performed in 72.7% of cases. About 53% of births was preterm with most of them linked to antepartum cases. Maternal and neonatal deaths were rare but more frequent in Suriname.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The declining incidence of eclampsia in Europe may be attributed to enhanced management, supported by ongoing audits and confidential enquiries; however, potential ascertainment bias limits causal interpretation. Global efforts remain crucial to promote awareness, timely prevention and implement standardised management guidelines for eclampsia across all settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70216","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:41:11Z","timestamp":1774521671000},"page":"1631-1642","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Eclampsia Incidence, Management and Outcomes Across Multi\u2010Country Surveillance Cohorts: Individual Participant Data Meta\u2010Analysis"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7793-9612","authenticated-orcid":false,"given":"Silvia","family":"Salvi","sequence":"first","affiliation":[{"name":"National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanit\u00e0\u2014Italian National Institute of Health  Rome Italy"},{"name":"Dipartimento Scienze Della Vita e Sanit\u00e0 Pubblica Universit\u00e0 Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Mandolini","sequence":"additional","affiliation":[{"name":"National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanit\u00e0\u2014Italian National Institute of Health  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitty W. M.","family":"Bloemenkamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Birth Centre Wilhelmina Children Hospital, Division Women and Baby University Medical Centre Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-3321","authenticated-orcid":false,"given":"Catherine","family":"Deneux\u2010Tharaux","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, CRESS, Obstetrical Perinatal and Pediatric Lifelong Epidemiology Research Team, OPPaLE, INSERM, INRAE  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilde Marie","family":"Engjom","sequence":"additional","affiliation":[{"name":"Division of Public Health and Prevention, Department of Health Promotion Norwegian Institute of Public Health  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lachmi R.","family":"Kodan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Academic Hospital of Paramaribo  Paramaribo Suriname"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Korb","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, CRESS, Obstetrical Perinatal and Pediatric Lifelong Epidemiology Research Team, OPPaLE, INSERM, INRAE  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Kri\u0161t\u00fafkov\u00e1","sequence":"additional","affiliation":[{"name":"First Department of Obstetrics and Gynaecology of Faculty of Medicine Comenius University and University Hospital  Bratislava Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Klungs\u00f8yr","sequence":"additional","affiliation":[{"name":"Division of Public Health and Prevention, Department of Health Promotion Norwegian Institute of Public Health  Bergen Norway"},{"name":"Department of Global Public Health and Primary Care University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Langedock","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Groeninge Hospital  Kortrijk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1437-2660","authenticated-orcid":false,"given":"Camilla Tj\u00f8nneland","family":"Mentzoni","sequence":"additional","affiliation":[{"name":"Division of Public Health and Prevention, Department of Health Promotion Norwegian Institute of Public Health  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam","family":"McCullough","sequence":"additional","affiliation":[{"name":"First Department of Obstetrics and Gynaecology of Faculty of Medicine Comenius University and University Hospital  Bratislava Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6784-8319","authenticated-orcid":false,"given":"Rema","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"Oxford NIHR Biomedical Research Centre  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. P. (Timme)","family":"Schaap","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Birth Centre Wilhelmina Children Hospital, Division Women and Baby University Medical Centre Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lien","family":"Seco","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, CRESS, Obstetrical Perinatal and Pediatric Lifelong Epidemiology Research Team, OPPaLE, INSERM, INRAE  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7420-5020","authenticated-orcid":false,"given":"Griet","family":"Vandenberghe","sequence":"additional","affiliation":[{"name":"Belgian Obstetric Surveillance System  Belgium"},{"name":"Department of Obstetrics and Gynecology Ghent University Hospital  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim J. 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