{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:10:07Z","timestamp":1790388607690,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,11,18]],"date-time":"2014-11-18T00:00:00Z","timestamp":1416268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Milinda Gates Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Preeclampsia\/eclampsia (<jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E) remains a major cause of maternal death in low\u2010income countries. We evaluated interventions to reduce <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E\u2010related maternal mortality in sub\u2010Saharan Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Mathematical model to assess impact of interventions on <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E\u2010related maternal morbidity and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Sub\u2010Saharan Africa countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Pregnant women in sub\u2010Saharan Africa in 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic literature review populated a decision\u2010tree mathematical model with interventions to diagnose, prevent, and treat women with <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E. The impact of increased use of interventions [diagnostics, transfer to a hospital, magnesium sulfate (Mg<jats:styled-content style=\"fixed-case\">SO<\/jats:styled-content><jats:sub>4<\/jats:sub>) use, cesarean section\/labor induction] on <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E\u2010related maternal mortality was analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Prevalence of <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E and <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E\u2010associated maternal mortality rates in sub\u2010Saharan Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Without interventions, an estimated 20\u00a0570 <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E\u2010associated deaths would have occurred in sub\u2010Saharan Africa in 2012. With current low rates of diagnosis, Mg<jats:styled-content style=\"fixed-case\">SO<\/jats:styled-content><jats:sub>4<\/jats:sub> use, transfers and cesarean section\/induction rates, about 17\u00a0520 maternal deaths were associated with <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E in 2012. Higher use of MgSO<jats:sub>4<\/jats:sub> would have prevented about 610 deaths. With high diagnostic levels, Mg<jats:styled-content style=\"fixed-case\">SO<\/jats:styled-content><jats:sub>4<\/jats:sub> use, transfer and cesarean section\/induction, mortality was reduced to 3750 annual deaths, saving about 13\u00a0770 maternal lives. If all Mg<jats:styled-content style=\"fixed-case\">SO<\/jats:styled-content><jats:sub>4<\/jats:sub> use was removed from the model, 4060 maternal deaths would occur, increasing maternal deaths by only 310.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In sub\u2010Saharan Africa, our model suggests that increasing use of <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E diagnostics, transfer to higher levels of care and increased hospitalization with cesarean section\/induction of labor would substantially reduce maternal mortality from <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/E. Increasing use of Mg<jats:styled-content style=\"fixed-case\">SO<\/jats:styled-content><jats:sub>4<\/jats:sub> would have a smaller impact on maternal mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12533","type":"journal-article","created":{"date-parts":[[2014,10,29]],"date-time":"2014-10-29T12:38:14Z","timestamp":1414586294000},"page":"148-155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Reducing maternal mortality from preeclampsia and eclampsia in low\u2010resource countries \u2013 what should work?"],"prefix":"10.1111","volume":"94","author":[{"given":"Robert L.","family":"Goldenberg","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Columbia University New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie","family":"Jones","sequence":"additional","affiliation":[{"name":"Social, Statistical and Environmental Sciences RTI International Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer B.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Social, Statistical and Environmental Sciences RTI International Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris J.","family":"Rouse","sequence":"additional","affiliation":[{"name":"Social, Statistical and Environmental Sciences RTI International Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beena D.","family":"Kamath\u2010Rayne","sequence":"additional","affiliation":[{"name":"Perinatal Institute Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehal","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Social, Statistical and Environmental Sciences RTI International Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"McClure","sequence":"additional","affiliation":[{"name":"Social, Statistical and Environmental Sciences RTI International Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,11,18]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Global burden of hypertensive disorders of pregnancy in the year 2000","author":"Dolea C","year":"2003"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2009.02.010"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60820-4"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60678-2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2011.09.011"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610903150802"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.01.002"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1331026"},{"key":"e_1_2_8_10_1","first-page":"771","article-title":"Maternal and perinatal mortality due to eclampsia","volume":"30","author":"Swain S","year":"1993","journal-title":"Indian Pediatr"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2011.03.005"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0044484"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0b013e3181c60ca6"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2012.01.028"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60321-9"},{"key":"e_1_2_8_17_1","unstructured":"United Nations.Life\u2010saving commodities. 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