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Health Care Science 2023, 2(1): 45-59 https://doi.org/10.1002/hcs2.28
Original Article | Open Access | Issue | Published: 21 December 2022

Socioeconomic and epidemiological milieu of maternal death due to eclampsia in West Bengal, India: A mixed methods study

Show Author's Information Md Illias Kanchan Sk ( )
International Institute for Population Sciences, Mumbai, India
Keywords:
India, eclampsia, maternal mortality, determinants, West Bengal
Cite this article:
Sk MIK. Socioeconomic and epidemiological milieu of maternal death due to eclampsia in West Bengal, India: A mixed methods study. Health Care Science, 2023, 2(1): 45-59. https://doi.org/10.1002/hcs2.28
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Abstract Full text About this article
Background

West Bengal is experiencing an unanticipated risk of eclampsia among pregnant women and it persists as the leading cause of maternal mortality. This study aimed to investigate the predictors for maternal deaths due to eclampsia in West Bengal.

Methods

The study adopted retrospective mixed methods covering facility and community‐based maternal death review approaches. Facility‐based data were used for 317 deceased cases wherein the community‐based review approach was used in 40 cases. An in‐depth interview was also performed among 12 caregivers.

Results

One‐third of maternal deaths occurred due to eclampsia, and this accounted for the leading cause of maternal deaths in West Bengal. A younger age, a primigravida or nulliparous status, absence of antenatal care (ANC), and residence in rural areas appeared to have the highest risk of developing eclampsia. The majority of pregnant women had an irregular antenatal check‐up history, particularly during the second trimester of pregnancy. The rate of eclampsia‐related maternal death was higher in women residing more than 49 km from the studied hospitals. Most of the deceased women were referred to three or more hospitals before their death. Gravidity, the number of ANC visits, the mode of delivery, and delays at different levels were significant confounders of death due to eclampsia. The risk of death due to eclampsia was two times higher among women without ANC and those who had a cesarean section than that in their counterparts.

Conclusions

Women in West Bengal have a high risk of preeclampsia and eclampsia resulting in maternal mortality and morbidity. Gravidity, the number of ANC visits, the mode of delivery, and delays in recognition of eclampsia contribute to the risk of maternal deaths. The establishment of separate eclampsia units, enhanced screening, and preventive and treatment procedures may optimize managing eclampsia.


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About this article

Socioeconomic and epidemiological milieu of maternal death due to eclampsia in West Bengal, India: A mixed methods study

Show Author's information Md Illias Kanchan Sk ( )
International Institute for Population Sciences, Mumbai, India

Abstract

Background

West Bengal is experiencing an unanticipated risk of eclampsia among pregnant women and it persists as the leading cause of maternal mortality. This study aimed to investigate the predictors for maternal deaths due to eclampsia in West Bengal.

Methods

The study adopted retrospective mixed methods covering facility and community‐based maternal death review approaches. Facility‐based data were used for 317 deceased cases wherein the community‐based review approach was used in 40 cases. An in‐depth interview was also performed among 12 caregivers.

Results

One‐third of maternal deaths occurred due to eclampsia, and this accounted for the leading cause of maternal deaths in West Bengal. A younger age, a primigravida or nulliparous status, absence of antenatal care (ANC), and residence in rural areas appeared to have the highest risk of developing eclampsia. The majority of pregnant women had an irregular antenatal check‐up history, particularly during the second trimester of pregnancy. The rate of eclampsia‐related maternal death was higher in women residing more than 49 km from the studied hospitals. Most of the deceased women were referred to three or more hospitals before their death. Gravidity, the number of ANC visits, the mode of delivery, and delays at different levels were significant confounders of death due to eclampsia. The risk of death due to eclampsia was two times higher among women without ANC and those who had a cesarean section than that in their counterparts.

Conclusions

Women in West Bengal have a high risk of preeclampsia and eclampsia resulting in maternal mortality and morbidity. Gravidity, the number of ANC visits, the mode of delivery, and delays in recognition of eclampsia contribute to the risk of maternal deaths. The establishment of separate eclampsia units, enhanced screening, and preventive and treatment procedures may optimize managing eclampsia.

Keywords: India, eclampsia, maternal mortality, determinants, West Bengal

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Publication history
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Publication history

Received: 08 October 2022
Accepted: 04 November 2022
Published: 21 December 2022
Issue date: February 2023

Copyright

© 2022 The Authors. Health Care Science published by John Wiley & Sons Ltd on behalf of Tsinghua University Press.

Acknowledgements

ACKNOWLEDGMENTS

I would like to thank the Principals and Registrars of Kolkata and Malda Medical Colleges and Hospitals for providing maternal death‐related data. I am grateful to Prof. Balram Paswan and Prof. T. K. Naskar for their continuous insight and guidance during my research. I am also thankful to Mr. Sandeep Chatterjee, Mr. Samiun Mondal, and Dr. Ismile Sheikh, the assistant superintendent of the respective medical college and hospitals, for their help in completinge this study. The author received no financial support for the research, authorship, and/or publication of this article.

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This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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