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World Preeclampsia Day Proclamation
On the occasion of the second World Preeclampsia Day on May 22, 2018, we have signed this proclamation to highlight our support of a worldwide initiative to raise awareness of preeclampsia and its global impact on the lives of mothers, babies and families.
We join together to highlight the common occurrence and devastating impact of preeclampsia, eclampsia, and other hypertensive disorders of pregnancy (HDPs).
The HDPs complicate 8-10% of pregnancies worldwide.1
The HDPs are a leading cause of maternal and infant death, worldwide. In absolute terms, this means approximately 76,000 maternal and 500,000 infant deaths every year.2 As a proportion, the HDPs are responsible for an estimated 16% of maternal deaths in LMICs7, and specifically, a quarter of maternal deaths in Latin America6 and a tenth of maternal deaths in Africa and Asia.5
Maternal deaths related to the HDPs are preventable.
The HDPs are also a leading cause of maternal and infant illness. Preeclampsia is a common cause of caregiver-initiated preterm delivery and accounts for approximately 20% of all intensive care unit admissions of newborn babies3. For the mother, complications of the HDPs can cause complications with long-lasting sequelae, such as stroke, and the HDPs are strongly associated with a heightened risk of future risk of cardiovascular disease, the leading non-communicable disease (NCD), worldwide.4
The WHO has highlighted that the NCDs, like the HDPs, have a disproportionately high impact in low-to-middle income countries (LMICs)5, where more than 99% of preeclampsia cases occur.6
Too many lives are taken or seriously affected by these disorders and the NCDs that result from them, underscoring the importance of detection and prevention, symptom recognition, and timely and effective response by trained healthcare workers. This is especially true in countries where access to care is limited.8 With no known cause, the need for basic and clinical research to advance our medical understanding and healthcare practices must be prioritized.
We support all efforts that:
- Call upon governments and health systems to recognize the importance of detecting and diagnosing risk factors, and preventing and treating the HDPs and related NCDs;
- Encourage additional research funding into preeclampsia and related disorders;
- Prioritize patient and community education and treatment for these disorders;
- Prioritize education, training, and access to medical resources for healthcare providers;
- Address prevention through a better understanding of the causes and through access to appropriate, safe, and effective treatments;
- Encourage collaboration and partnerships between public and private sector organizations to support and advance these goals.
Working individually and in partnership, we must continue to shine a strong light on HDP and related NCDs to ensure that they are minimized and their tragic impact reduced.
The opportunity to reduce the prevalence of these disorders and their impact on women, infants, families, and communities worldwide is within our grasp.
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Footnotes for the proclamation
- Ye, C., Ruan, Y., Zou, L., Li, G., Li, C., Chen, Y., … Zhang, W. (2014). The 2011 Survey on Hypertensive Disorders of Pregnancy (HDP) in China: Prevalence, Risk Factors, Complications, Pregnancy and Perinatal Outcomes. PLoS ONE, 9(6), e100180. http://doi.org/10.1371/journal.pone.0100180
- Salam R. A., Das, J. K., Ali, A., Bhuamik, S., and Lassi, Z.S. (2015). Diagnosis and management of preeclampsia in community settings in low and middle-income countries. Journal of Family Med Prim Care, 4(4), 501–506. http://doi.org/10.4103/2249-4863.174265
- Habli M, Levine RJ, Qian C, Sibai B. Neonatal outcomes in pregnancies with preeclampsia or gestational hypertension and in normotensive pregnancies that delivered at 35, 36, or 37 weeks of gestation. Am J Obstet Gynecol. 2007 Oct;197(4):406.e1-7. PubMed PMID: 17904980.
- Mongraw-Chaffin ML, Cirillo PM, Cohn BA. Preeclampsia and cardiovascular disease death: prospective evidence from the child health and development studies cohort. Hypertension 2010;56: 166–71.
- WHO recommendations for Prevention and treatment of pre-eclampsia and eclampsia. (2011). World Health Organisation.
- von Dadelszen, P., Firoz, T., Donnay, F., Gordon, R., Hofmeyr, J., Lalani, S., Payne, B.A., Roberts, J.M, Teela, K.C., Vidler, M., Sawchuck, D. and Magee, L. (2012). Preeclampsia in Low and Middle Income Countries, Health Services Lessons Learned From the PRE-EMPT (PRE-Eclampsia–Eclampsia Monitoring, Prevention & Treatment) Project. Journal of Obstetrics and Gynaecology Canada, 34(10), 917–926. http://dx.doi.org/10.1016/S1701-2163(16)35405-65.
- Firoz, T., Sanghiv, H., Merialdi, Marlo., von Dadelszen, P. (2011). Pre-eclampsia in low and middle income countries. Best Practice & Research Clinical Obstetrics and Gynaecology, 25, 537–548. https://doi.org/10.1016/j.bpobgyn.2011.04.002
- Filippi, V., Ronsmans, C., Campbell, O. M. R., Graham, W. J., Mills, A., Borghi, J., Koblinsky, M., Osrin, D. (2006). Maternal health in poor countries: the broader context and a call for action. Maternal Survival, 5. http://doi.org/10.1016/S0140-6736(06)69384-7