{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:31:23Z","timestamp":1760146283377,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Introduction. Eclampsia is a rare complication that can occur during pregnancy and has a significant impact on maternal and neonatal outcomes. The aim of this study was to investigate the risk factors associated with significant maternal morbidity after an eclamptic seizure. (2) Methods. An observational retrospective study was performed in three maternity hospitals in Romania between 2015 and 2023 and included pregnant patients diagnosed with eclampsia. Clinical and paraclinical data were investigated, and the impact of several risk factors was assessed using multiple logistic regression analysis. The results were reported as risk ratios (RRs) and 95% confidence intervals (Cis). (3) Results. A total of 104 patients with preeclampsia, of whom 23 experienced eclamptic seizures, were included in this study. A total of 82.6% of the patients diagnosed with eclampsia experienced a form of significant morbidity (stroke, PRES syndrome, or any organ failure\/dysfunction). Our regression analysis revealed that advanced maternal age (RR: 12.24 95% CI: 4.29\u201336.61, p = 0.002), the presence of thrombotic disorders (RR: 9.17, 95% CI: 3.41\u201323.70, p = 0.03), obesity (RR: 4.89, 95% CI: 0.78\u201318.15, p = 0.036), and smoking status (RR: 2.18, 95% CI: 0.13- 6.51, p = 0.042) significantly increase the risk of maternal comorbidities. (4) Conclusions. Careful monitoring of pregnant patients, adequate weight control during pregnancy, and correct anticoagulation of individual patients could reduce the extent of postpartum comorbidities that can result from an eclamptic seizure.<\/jats:p>","DOI":"10.3390\/jcm13216384","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T08:42:13Z","timestamp":1729845733000},"page":"6384","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated with Maternal Morbidity in Patients with Eclampsia in Three Obstetric Intensive Care Units: A Retrospective Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9251-1344","authenticated-orcid":false,"given":"Carolina","family":"Susanu","sequence":"first","affiliation":[{"name":"Clinical and Surgical Department, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University, 800008 Galati, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid-Andrada","family":"Vasilache","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Care, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anamaria","family":"Harabor","sequence":"additional","affiliation":[{"name":"Clinical and Surgical Department, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University, 800008 Galati, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petronela","family":"Vicoveanu","sequence":"additional","affiliation":[{"name":"Department of Mother and Newborn Care, Faculty of Medicine and Biological Sciences, \u201c\u0218tefan cel Mare\u201d University, 720229 Suceava, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina-Mihaela","family":"C\u0103lin","sequence":"additional","affiliation":[{"name":"Clinical and Surgical Department, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University, 800008 Galati, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kornacki, J., Olejniczak, O., Sibiak, R., Gutaj, P., and Wender-O\u017cegowska, E. (2023). Pathophysiology of Pre-Eclampsia-Two Theories of the Development of the Disease. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25010307"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"370","DOI":"10.3892\/etm.2022.11297","article-title":"Predictive performance of first trimester serum galectin-13\/PP-13 in preeclampsia screening: A systematic review and meta-analysis","volume":"23","author":"Vasilache","year":"2022","journal-title":"Exp. Ther. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Vasilache, I.A., Scripcariu, I.S., Doroftei, B., Bernad, R.L., C\u0103r\u0103uleanu, A., Socolov, D., Melinte-Popescu, A.S., Vicoveanu, P., Harabor, V., and Mihalceanu, E. (2024). Prediction of Intrauterine Growth Restriction and Preeclampsia Using Machine Learning-Based Algorithms: A Prospective Study. Diagnostics, 14.","DOI":"10.3390\/diagnostics14040453"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Melinte-Popescu, A.-S., Vasilache, I.-A., Socolov, D., and Melinte-Popescu, M. (2023). Predictive Performance of Machine Learning-Based Methods for the Prediction of Preeclampsia\u2014A Prospective Study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12020418"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.preghy.2021.09.008","article-title":"The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice","volume":"27","author":"Magee","year":"2022","journal-title":"Pregnancy Hypertens"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1097\/AOG.0000000000000746","article-title":"Pregnancy-related mortality in California: Causes, characteristics, and improvement opportunities","volume":"125","author":"Main","year":"2015","journal-title":"Obstet. Gynecol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"(2020). Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet. Gynecol., 135, e237\u2013e260.","DOI":"10.1097\/AOG.0000000000003891"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S1237","DOI":"10.1016\/j.ajog.2020.09.037","article-title":"Eclampsia in the 21st century","volume":"226","author":"Sibai","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1053\/j.semperi.2011.09.011","article-title":"Maternal mortality from preeclampsia\/eclampsia","volume":"36","author":"Ghulmiyyah","year":"2012","journal-title":"Semin. Perinatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"476.e1","DOI":"10.1016\/j.ajog.2013.02.042","article-title":"The incidence of preeclampsia and eclampsia and associated maternal mortality in Australia from population-linked datasets: 2000-2008","volume":"208","author":"Thornton","year":"2013","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1017\/S0965539511000040","article-title":"Seizures in Women with Preeclampsia: Mechanisms and Management","volume":"22","author":"Cipolla","year":"2011","journal-title":"Fetal Matern. Med. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.preghy.2020.10.013","article-title":"Neuropathophysiology of preeclampsia and eclampsia: A review of cerebral hemodynamic principles in hypertensive disorders of pregnancy","volume":"23","author":"Mahendra","year":"2021","journal-title":"Pregnancy Hypertens."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1161\/HYPERTENSIONAHA.122.19408","article-title":"Brain Vascular Dysfunction in Mothers and Their Children Exposed to Preeclampsia","volume":"80","author":"Escudero","year":"2023","journal-title":"Hypertension"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1081\/PRG-120021066","article-title":"Severe maternal morbidity associated with hypertensive disorders in pregnancy in the United States","volume":"22","author":"Zhang","year":"2003","journal-title":"Hypertens. Pregnancy"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.ajem.2022.06.004","article-title":"High risk and low prevalence diseases: Eclampsia","volume":"58","author":"Boushra","year":"2022","journal-title":"Am. J. Emerg. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1097\/AOG.0b013e31823311c1","article-title":"Incidence, risk factors, and associated complications of eclampsia","volume":"118","author":"Liu","year":"2011","journal-title":"Obstet. Gynecol."},{"key":"ref_17","first-page":"183","article-title":"Posterior reversible encephalopathy syndrome (PRES): Diagnosis and management","volume":"22","author":"Triplett","year":"2022","journal-title":"Pract. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"405.e1","DOI":"10.1016\/j.ajog.2018.07.002","article-title":"Contribution of hypertension to severe maternal morbidity","volume":"219","author":"Hitti","year":"2018","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"415.e1","DOI":"10.1016\/j.ajog.2017.01.008","article-title":"Early standardized treatment of critical blood pressure elevations is associated with a reduction in eclampsia and severe maternal morbidity","volume":"216","author":"Shields","year":"2017","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1097\/AOG.0b013e31826d60c5","article-title":"Severe maternal morbidity among delivery and postpartum hospitalizations in the United States","volume":"120","author":"Callaghan","year":"2012","journal-title":"Obstet. Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1111\/1471-0528.12712","article-title":"Eclampsia, a comparison within the International Network of Obstetric Survey Systems","volume":"121","author":"Schaap","year":"2014","journal-title":"BJOG"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1097\/AOG.0000000000002364","article-title":"Long-term Risk of a Seizure Disorder After Eclampsia","volume":"130","author":"Nerenberg","year":"2017","journal-title":"Obstet. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1002\/ijgo.13347","article-title":"Long-term seizure recurrence after eclampsia: A systematic review and meta-analysis","volume":"151","author":"Barber","year":"2020","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1002\/ijgo.14540","article-title":"Hypertensive disorders of pregnancy and long-term cardiovascular health: FIGO Best Practice Advice","volume":"160","author":"Poon","year":"2023","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1111\/aogs.12882","article-title":"Eclampsia in Finland; 2006 to 2010","volume":"95","author":"Jaatinen","year":"2016","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"102473","DOI":"10.1016\/j.bpobgyn.2024.102473","article-title":"Preventing maternal morbidity and mortality from preeclampsia and eclampsia particularly in low- and middle-income countries","volume":"94","author":"Ngene","year":"2024","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/1471-0528.12629","article-title":"Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes: A secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health","volume":"121","author":"Abalos","year":"2014","journal-title":"BJOG"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/10641950701826612","article-title":"Eclampsia, study of 342 cases","volume":"27","author":"Miguil","year":"2008","journal-title":"Hypertens. Pregnancy"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1097\/AOG.0b013e3182324570","article-title":"Characterization of symptoms immediately preceding eclampsia","volume":"118","author":"Cooray","year":"2011","journal-title":"Obstet. Gynecol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e1002775","DOI":"10.1371\/journal.pmed.1002775","article-title":"Incidence of eclampsia and related complications across 10 low- and middle-resource geographical regions: Secondary analysis of a cluster randomised controlled trial","volume":"16","author":"Vousden","year":"2019","journal-title":"PLoS Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3266","DOI":"10.1080\/14767058.2018.1462323","article-title":"Incidence and natural history of preeclampsia\/eclampsia at the university maternity of Antananarivo, Madagascar: High prevalence of the early-onset condition","volume":"32","author":"Ratsiatosika","year":"2019","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1097\/AOG.0000000000003290","article-title":"Systolic Hypertension, Preeclampsia-Related Mortality, and Stroke in California","volume":"133","author":"Judy","year":"2019","journal-title":"Obstet. Gynecol."},{"key":"ref_33","first-page":"e939919","article-title":"Eclampsia: A Critical Pregnancy Complication Demanding Enhanced Maternal Care: A Review","volume":"29","author":"Laskowska","year":"2023","journal-title":"Med. Sci. Monit."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"579293","DOI":"10.3389\/fped.2020.579293","article-title":"Neonatal Outcome After Preeclampsia and HELLP Syndrome: A Population-Based Cohort Study in Germany","volume":"8","author":"Bossung","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/ppe.12184","article-title":"Placental abruption and subsequent risk of pre-eclampsia: A population-based case-control study","volume":"29","author":"Parker","year":"2015","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"S1313","DOI":"10.1016\/j.ajog.2022.06.059","article-title":"Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management","volume":"228","author":"Brandt","year":"2023","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.1007\/s40620-022-01349-2","article-title":"Pregnancy-related acute kidney injury in the African continent: Where do we stand? A systematic review","volume":"35","author":"Shalaby","year":"2022","journal-title":"J. Nephrol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1097\/AOG.0b013e31823556c6","article-title":"Disparity in the rate of eclampsia and adverse pregnancy outcome from eclampsia: A tale of two countries","volume":"118","author":"Sibai","year":"2011","journal-title":"Obstet. Gynecol."},{"key":"ref_39","unstructured":"Davis, N.L., Smoots, A.N., and Goodman, D.A. (2024, September 01). Pregnancy-Related Deaths: Data from 14 U.S. Maternal Mortality Review Committees, 2008\u20132017, Available online: https:\/\/archive.cdc.gov\/www_cdc_gov\/reproductivehealth\/maternal-mortality\/erase-mm\/MMR-Data-Brief_2019-h.pdf."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"100163","DOI":"10.1016\/j.gpeds.2024.100163","article-title":"Differences in neonatal outcomes between normal and preeclampsia complicated pregnancies","volume":"8","author":"Mitrovic","year":"2024","journal-title":"Glob. Pediatr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.ajog.2016.09.076","article-title":"The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: Systematic review and meta-analysis","volume":"216","author":"Roberge","year":"2017","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Savin, M.L., Mihai, F., Gheorghe, L., Lupascu Ursulescu, C., Negru, D., Trofin, A.M., Zabara, M., Nutu, V., Cadar, R., and Blaj, M. (2021). Proposal of a Preoperative CT-Based Score to Predict the Risk of Clinically Relevant Pancreatic Fistula after Cephalic Pancreatoduodenectomy. Medicina, 57.","DOI":"10.3390\/medicina57070650"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Adam, A.M., Popa, R.F., Vaduva, C., Georgescu, C.V., Adam, G., Melinte-Popescu, A.S., Popa, C., Socolov, D., Nechita, A., and Vasilache, I.A. (2023). Pregnancy Outcomes, Immunophenotyping and Immunohistochemical Findings in a Cohort of Pregnant Patients with COVID-19-A Prospective Study. Diagnostics, 13.","DOI":"10.3390\/diagnostics13071345"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Melinte-Popescu, A.S., Popa, R.F., Harabor, V., Nechita, A., Harabor, A., Adam, A.M., Vasilache, I.A., Melinte-Popescu, M., Vaduva, C., and Socolov, D. (2023). Managing Fetal Ovarian Cysts: Clinical Experience with a Rare Disorder. Medicina, 59.","DOI":"10.3390\/medicina59040715"},{"key":"ref_45","first-page":"435","article-title":"Morphological and ultrasound findings in multiple pregnancy placentation","volume":"59","author":"Berceanu","year":"2018","journal-title":"Rom. J. Morphol. Embryol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/21\/6384\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:20:03Z","timestamp":1760113203000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/21\/6384"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,25]]},"references-count":45,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["jcm13216384"],"URL":"https:\/\/doi.org\/10.3390\/jcm13216384","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2024,10,25]]}}}