Evidence map›Paper›PMID 40366218›Full record

ArticleActa obstetricia et gynecologica Scandinavica2025

Risk factors associated with progression from pre-eclampsia to eclampsia: A prospective cohort study and population-wide data analysis.

Annettee Nakimuli, Brittany A Jasper, Sarah Nakubulwa, Moses Adroma, Jackline Akello, Imelda Namagembe, Musa Sekikubo, Eve Nakabembe, Ashley Moffett, Catherine E Aiken

Abstract read
In one paragraph

Article in Acta obstetricia et gynecologica Scandinavica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Annettee NakimuliDepartment of Obstetrics and Gynaecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda.
Brittany A JasperDepartment of Obstetrics and Gynaecology, University of Cambridge, The Rosie Hospital and NIHR Cambridge Biomedical Research Centre, Cambridge, UK.ORCID https://orcid.org/0000-0003-0507-3105
Sarah NakubulwaDepartment of Obstetrics and Gynaecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda.
Moses AdromaDepartment of Obstetrics and Gynaecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda.
Jackline AkelloDepartment of Obstetrics and Gynaecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda.
Imelda NamagembeDepartment of Obstetrics and Gynaecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda.
Musa SekikuboDepartment of Obstetrics and Gynaecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda.
Eve NakabembeDepartment of Obstetrics and Gynaecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda.
Ashley MoffettDepartment of Pathology and Centre for Trophoblast Research, University of Cambridge, Cambridge, UK.
Catherine E AikenDepartment of Obstetrics and Gynaecology, University of Cambridge, The Rosie Hospital and NIHR Cambridge Biomedical Research Centre, Cambridge, UK.

Funding

NURTURE:Research Training and Mentoring Program for Career Development of Faculty at Makerere University College of Health SciencesD43TW010132 · FIC · MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES · PI SEWANKAMBO, NELSON K · 2015 to 2019
$4.3M
DELTAS Africa InitiativeFIC NIH HHS D43 TW010132NIHR Cambridge Biomedical Research CentreNURTURE D43TW010132Wellcome TrustWellcome Trust 084344Wellcome Trust 094073/Z/10/BWellcome Trust 107743/Z/15/Z
6 · The paper itself

Abstract

introductionEclampsia is a life-threatening complication of pre-eclampsia. There are currently no means of reliably identifying women with pre-eclampsia who are at the highest risk of progression to eclampsia and would thus benefit from prioritization for intensive monitoring and urgent delivery. This is particularly challenging in obstetric settings where resources are limited. We identify risk factors for the progression of pre-eclampsia to eclampsia in low- and middle-income settings. MATERIAL AND

methodsWomen diagnosed with pre-eclampsia were prospectively recruited at a single tertiary referral centre in urban Uganda (2011-2016). Multivariable logistic regression models were used to identify risk factors that predicted the likelihood of progression to eclampsia. Key findings were validated in a geographically, socioeconomically, and ethnically distinct population using population-wide hospital admission data from Ecuador (2021-2023).

resultsIn urban Uganda, progression from pre-eclampsia to eclampsia was associated with nulliparity (OR 2.4; 95% CI: 1.1-5.4, p = 0.03), Baganda ethnicity (OR 1.9; 95% CI: 1.1-3.9, p = 0.01), unskilled/unemployed paternal occupation (OR 2.8; 95% CI: 1.3-6.4, p = 0.03), and a trend toward younger maternal age (OR 0.9; 95% CI: 0.9-1.0 per year; p = 0.09). Risk of progression to eclampsia was not related to the severity of pre-eclampsia or the number of antenatal clinic visits. In Ecuador, population-wide analysis showed that progression to eclampsia was associated with younger maternal age (p < 0.001) and a trend toward public vs privately funded obstetric care (p = 0.09).

conclusionsEclampsia risk extends beyond clinical markers of pre-eclampsia severity, with socioeconomic factors and maternal age playing crucial roles in disease progression. A targeted, context-specific approach prioritizing high-risk young women with socioeconomic vulnerabilities could optimize healthcare resources and mitigate severe hypertensive disorder risks.

Indexed as

EclampsiaPre-EclampsiaAdultDisease ProgressionEcuadorFemaleHumansPregnancyProspective StudiesRisk FactorsSocioeconomic FactorsUgandaYoung Adultlow‐resource settingmaternal agemortalityobstetricspregnancyrisk factorssocioeconomic status

Identifiers

PMID40366218
PMCPMC12283159

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.