Academic Journal
Spatiotemporal trends and regional inequities in preeclampsia and eclampsia in Brazil, 2008-2023.
| Title: | Spatiotemporal trends and regional inequities in preeclampsia and eclampsia in Brazil, 2008-2023. |
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| Authors: | Nascimento CMC; Universidade Federal Fluminense. Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Faculdade de Medicina. Niterói, RJ, Brazil; Universidade Federal Fluminense. Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Niterói, RJ, Brazil. Electronic address: carvalho_camila@id.uff.br., Ramos-Silva A; Universidade Federal do Rio de Janeiro. Faculdade de Farmácia. Rio de Janeiro, RJ, Brazil. Electronic address: alice.ramos@farmacia.ufrj.br., Marcolino LA; Universidade Federal Fluminense. Faculdade de Medicina. Niterói, RJ, Brazil. Electronic address: luciano.marcolino@yahoo.com., das Neves E Silva NP; Universidade Federal Fluminense. Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Faculdade de Medicina. Niterói, RJ, Brazil. Electronic address: nathneves@hotmail.com., Lima EC; Universidade Federal do Rio de Janeiro. Faculdade de Farmácia. Rio de Janeiro, RJ, Brazil. Electronic address: eclima.ufrj@gmail.com., Carvalho FR; Universidade Federal Fluminense. Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Niterói, RJ, Brazil; Universidade Federal Fluminense. Programa de Pós-graduação em Patologia, Faculdade de Medicina. Niterói, RJ 24033900, Brazil. Electronic address: fabianarc@id.uff.br., Lugon JR; Universidade Federal Fluminense. Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Faculdade de Medicina. Niterói, RJ, Brazil; Universidade Federal Fluminense. Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Niterói, RJ, Brazil; Universidade Federal Fluminense. Faculdade de Medicina. Niterói, RJ, Brazil. Electronic address: jrlugon@id.uff.br. |
| Source: | Pregnancy hypertension [Pregnancy Hypertens] 2026 Jun; Vol. 44, pp. 101447. Date of Electronic Publication: 2026 Mar 10. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101552483 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2210-7797 (Electronic) Linking ISSN: 22107789 NLM ISO Abbreviation: Pregnancy Hypertens Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Amtserdam : Elsevier |
| MeSH Terms: | Pre-Eclampsia*/epidemiology , Pre-Eclampsia*/mortality , Eclampsia*/epidemiology , Eclampsia*/mortality, Brazil/epidemiology ; Maternal Mortality/trends ; Hospitalization/statistics & numerical data ; Hospitalization/trends ; Hospital Mortality/trends ; Humans ; Female ; Pregnancy ; Adult ; Adolescent ; Retrospective Studies ; Child ; Young Adult ; Middle Aged ; Spatio-Temporal Analysis |
| Abstract: | Objectives: To analyze the spatiotemporal distribution of preeclampsia and eclampsia in Brazil over 16 years. Study Design: Retrospective study (2008-2023) using nationwide SUS data. Women aged 10-49 years with ICD-10 codes O14 and O15 were included. Main Outcome Measures: Hospitalization and maternal mortality rates per 100,000 estimated pregnancies; in-hospital mortality; and Disability-Adjusted Life Years (DALYs). Spatial patterns were assessed using Global Moran's I and Local Indicators of Spatial Association (LISA), and trends using Joinpoint and Mann-Kendall tests. Results: Of 877,555 hospitalizations identified, the national rate rose from 38.2 to 86.3 per 1,000 pregnancies (AAPC = 5.7%; p < 0.001). The Northeast had the highest average rate (74.1) and sustained growth. Spatial analysis revealed significant clustering for hospitalization (Moran's I = 0.565) and mortality (Moran's I = 0.121), with hotspots in the Northeast and Southeast (Minas Gerais). Eclampsia caused 18.4% of maternal deaths. While national DALY trends were stable, driven by the mortality component (YLL > 99%), the Central-West showed a significant decline (tau = - 0.55; p = 0.0034). DALY rates were highest in the North (mean = 8.26) and lowest in the South (mean = 3.28). Conclusions: Preeclampsia/eclampsia hospitalizations are rising in Brazil, yet persistent mortality exposes a quality chasm exacerbated by workforce shortages and SUS underfunding. Addressing these inequities requires strengthening surveillance and referral systems to ensure dignified, high-quality care and reduce the disease burden. (Copyright © 2026 The Author(s). Published by Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Brazil; Eclampsia; Hospitalization; Maternal Mortality; Preeclampsia; Public Health; Spatial Analysis |
| Entry Date(s): | Date Created: 20260311 Date Completed: 20260612 Latest Revision: 20260612 |
| Update Code: | 20260613 |
| DOI: | 10.1016/j.preghy.2026.101447 |
| PMID: | 41812516 |
| Database: | MEDLINE |
| ISSN: | 2210-7797 |
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| DOI: | 10.1016/j.preghy.2026.101447 |