PREVALENCE AND RISK FACTORS OF ECLAMPSIA AMONG PREGNANT WOMEN IN A SELECTED COMMUNITY GENERAL HOSPITAL BAJOGA

CHAPTER ONE: INTRODUCTION
1.1 Background to the Study
Eclampsia remains one of the most devastating obstetric emergencies worldwide, constituting a major cause of maternal and perinatal morbidity and mortality. It is defined as the occurrence of generalized tonic-clonic convulsions in a woman with preeclampsia, not attributable to other causes (Akaba et al., 2021). As the severe end of the spectrum of hypertensive disorders of pregnancy, eclampsia poses significant threats to the health and survival of both mother and fetus, particularly in low- and middle-income countries where access to quality antenatal and emergency obstetric care is limited.
Globally, hypertensive disorders of pregnancy affect approximately 5–10% of pregnancies and are responsible for substantial maternal deaths (World Health Organization, 2020). Sub-Saharan Africa bears a disproportionate burden of preeclampsia-related maternal deaths, with over 99% of such deaths occurring in low-income and middle-income countries (Okereke et al., 2025). Nigeria, in particular, has one of the highest maternal mortality ratios globally, estimated at 1,047 maternal deaths per 100,000 live births as of 2020 (Kokori et al., 2024). Preeclampsia and eclampsia are significant contributors to this alarming statistic, with a pooled prevalence of 4.51% for preeclampsia and 1.39% for eclampsia among pregnant women in Nigeria (Kokori et al., 2024).
The burden of eclampsia in Nigeria varies across regions and healthcare facilities. Studies have reported prevalence rates ranging from 0.58% to 7.0% of all pregnancies (Akaba et al., 2021; Adebayo et al., 2024). In Gombe State, northeastern Nigeria, where Bajoga is located, the prevalence of eclampsia has been documented at 1.57%, with the disease being most prevalent among teenagers (Muhammad et al., 2023). This high prevalence is particularly concerning given that over one-quarter of women with eclampsia in Nigeria die from the condition (Adebayo et al., 2024).
The risk factors for eclampsia are multifaceted and include both sociodemographic and clinical determinants. Advanced maternal age (over 35 years), lack of formal education, nulliparity, grand-multiparity, previous caesarean section, previous miscarriage, obesity, anaemia, and lack of antenatal care have all been identified as significant predictors of hypertensive disorders in pregnancy in Nigeria (Adebayo et al., 2024; Ajah et al., 2016). Additionally, nulliparity has been associated with an odds ratio of 4.77 for developing preeclampsia in Lagos, Nigeria (Adebayo et al., 2024).
Community General Hospital Bajoga, located in Gombe State, serves a predominantly rural population with limited access to specialized obstetric care. Understanding the prevalence and risk factors of eclampsia in this setting is crucial for developing targeted interventions to reduce maternal and perinatal morbidity and mortality. This study, therefore, seeks to investigate the prevalence and risk factors of eclampsia among pregnant women attending Community General Hospital Bajoga.
1.2 Statement of the Problem
Eclampsia remains a leading cause of maternal mortality in Nigeria, contributing significantly to the country's persistently high maternal mortality ratio. Despite various national and international efforts to improve maternal health, eclampsia continues to account for a substantial proportion of obstetric emergencies and maternal deaths in Nigerian healthcare facilities.
In Gombe State, where Bajoga is located, eclampsia has been identified as a major contributor to maternal morbidity and mortality, with a prevalence of 1.57% and a case fatality rate of 2.4% at Federal Teaching Hospital Gombe (Muhammad et al., 2023). However, little is known about the burden of eclampsia at the community hospital level, where most pregnant women in rural areas seek care. Community General Hospital Bajoga serves as a primary referral center for pregnant women from surrounding rural communities, yet there is a paucity of data on the prevalence and risk factors of eclampsia in this setting.
The lack of local epidemiological data hinders effective planning and implementation of preventive strategies. Without understanding the specific risk factors prevalent in this community, healthcare providers cannot adequately identify high-risk women or allocate resources efficiently. Furthermore, the high case fatality rate associated with eclampsia underscores the urgent need for early identification of at-risk women and prompt management of cases.
This study aims to address this gap by determining the prevalence and risk factors of eclampsia among pregnant women attending Community General Hospital Bajoga. The findings will provide evidence-based information for healthcare policymakers and providers to develop targeted interventions for the prevention and management of eclampsia in this community.
1.3 Objectives of the Study
1.3.1 General Objective
To determine the prevalence and risk factors of eclampsia among pregnant women attending Community General Hospital Bajoga, Gombe State, Nigeria.



1.3.2 Specific Objectives
1. To determine the prevalence of eclampsia among pregnant women attending Community General Hospital Bajoga.
2. To identify the sociodemographic factors associated with eclampsia among pregnant women in the study population.
3. To determine the clinical and obstetric risk factors for eclampsia among pregnant women in the study population.
4. To assess the maternal and perinatal outcomes of eclampsia cases at Community General Hospital Bajoga.
1.4 Research Questions
1. What is the prevalence of eclampsia among pregnant women attending Community General Hospital Bajoga?
2. What are the sociodemographic characteristics of pregnant women with eclampsia at Community General Hospital Bajoga?
3. What are the clinical and obstetric risk factors associated with eclampsia among pregnant women in the study population?
4. What are the maternal and perinatal outcomes of eclampsia cases at Community General Hospital Bajoga?
1.5 Research Hypotheses
H₀: There is no significant association between sociodemographic factors and the occurrence of eclampsia among pregnant women attending Community General Hospital Bajoga.
H₁: There is a significant association between sociodemographic factors and the occurrence of eclampsia among pregnant women attending Community General Hospital Bajoga.
H₀: There is no significant association between clinical/obstetric risk factors and the occurrence of eclampsia among pregnant women attending Community General Hospital Bajoga.
H₁: There is a significant association between clinical/obstetric risk factors and the occurrence of eclampsia among pregnant women attending Community General Hospital Bajoga.
1.6 Significance of the Study
This study is significant for several reasons. First, it will provide baseline epidemiological data on the prevalence and risk factors of eclampsia in a community hospital setting in Gombe State, filling a critical gap in the existing literature. Second, the findings will help healthcare providers and policymakers identify high-risk women and develop targeted preventive strategies, including improved antenatal screening and early referral systems.
Third, the study will contribute to the body of knowledge on maternal health in rural Nigeria, informing the development of evidence-based interventions to reduce maternal morbidity and mortality from eclampsia. Fourth, the results will serve as a benchmark for future research and program evaluation in the region. Finally, this study will provide recommendations for improving the quality of obstetric care at Community General Hospital Bajoga and similar facilities in resource-limited settings.
1.7 Scope of the Study
This study focuses on determining the prevalence and risk factors of eclampsia among pregnant women attending Community General Hospital Bajoga in Gombe State, Nigeria. The study will include all pregnant women diagnosed with eclampsia during the study period. The scope covers sociodemographic characteristics (age, education, occupation, marital status, place of residence), clinical and obstetric risk factors (parity, booking status, antenatal care attendance, history of hypertension, history of preeclampsia/eclampsia, gestational age at delivery, mode of delivery), and maternal and perinatal outcomes.
The study is limited to Community General Hospital Bajoga and may not be generalizable to other settings. However, the findings may be applicable to similar community hospitals in rural northeastern Nigeria.
1.8 Operational Definition of Terms
Eclampsia: The occurrence of generalized tonic-clonic convulsions in a woman with preeclampsia, not attributable to other causes (Akaba et al., 2021).
Preeclampsia: A hypertensive disorder of pregnancy characterized by new-onset hypertension (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) and proteinuria (≥300 mg/24 hours) occurring after 20 weeks of gestation (Akaba et al., 2021).
Prevalence: The proportion of pregnant women diagnosed with eclampsia out of the total number of deliveries during the study period, expressed as a percentage.
Risk Factor: Any characteristic, condition, or exposure that increases the likelihood of developing eclampsia.
Booking Status: Whether a pregnant woman has registered for antenatal care at a healthcare facility.
Unbooked: A pregnant woman who has not registered for antenatal care at any healthcare facility prior to delivery.
Primigravida: A woman who is pregnant for the first time.
Multipara: A woman who has had two or more pregnancies reaching viability.
Grand Multipara: A woman who has had five or more pregnancies reaching viability.
Antenatal Care (ANC): Healthcare services provided to pregnant women to monitor and promote the health of both mother and fetus throughout pregnancy.
Maternal Mortality: The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management.
Perinatal Mortality: The death of a fetus or newborn, including stillbirths (fetal deaths after 28 weeks of gestation) and early neonatal deaths (within the first 7 days of life).
Case Fatality Rate: The proportion of women with eclampsia who die from the condition.

    Date: 2026-07-31 00:00:00.000000