Pre-eclampsia and the life-threatening condition of eclampsia (seizures associated with this disorder) constitute an important contributor to the burden of bad maternal-newborn outcomes. Eclampsia/pre-eclampsia accounts globally for about 1 in 7 maternal deaths,4 with most (in high-mortality settings) resulting from eclampsia. In sub-Saharan Africa, 1 of every 1,500 pregnancies ends in a maternal death attributable to eclampsia/pre-eclampsia; in South Asia the proportion is about 1 in 3,000 (calculated from Kassebaum5). The importance of the problem has been recognized within the maternal health community, and this is reflected in the emphasis it has placed on use of magnesium sulfate for care of women with eclampsia and severe pre-eclampsia, for example, as one of the Emergency Obstetrical Care ‘‘signal functions’’.
Despite the important contribution of eclampsia/ pre-eclampsia to perinatal and newborn deaths, it has—for the most part—been absent from strategies elaborated globally to try to reduce the burden of such deaths. One could speculate this has been due in part to those in the newborn community seeing this problem as falling in the maternal health domain. On the maternal health side—as noted above—there has been attention to trying to ensure that when women arrive in hospital in a life-threatening state of eclampsia or severe pre-eclampsia they are appropriately treated with magnesium sulfate (though there is no evidence this helps reduce perinatal deaths). However, serious programmatic attention has not extended much further. This represents an important missed opportunity to achieve better outcomes
