Global prevalence of preeclampsia, eclampsia, and HELLP syndrome: a systematic review and meta-analysis
Abstract
Introduction Hypertensive disorders of pregnancy represent a leading cause of maternal and perinatal morbidity and mortality worldwide. However, prevalence estimates of preeclampsia, eclampsia, and HELLP syndrome vary considerably across studies and regions. Objective To determine the global prevalence of preeclampsia, eclampsia, and HELLP (Hemolysis, Elevated Liver enzymes, and Low Platelet count) syndrome, analyze their geographical distribution, and evaluate temporal and methodological trends. Methodology A systematic review with meta-analysis was conducted. SCOPUS, Web of Science, PubMed, and EMBASE databases were searched through May 2025. Observational studies reporting prevalence data using standardized diagnostic criteria were included. Prevalences were pooled using a random-effects model with Freeman-Tukey double arcsine transformation. Subgroup analyses by diagnostic criteria and countries and meta-regressions by publication year and sample size were performed. Results Seventy studies on preeclampsia (2,465,570 participants), 21 on eclampsia (9,782,257 participants), and nine on HELLP syndrome (133,611 participants) were analyzed. The global prevalence of preeclampsia was 4.43 (95% CI: 3.73–5.20), with significant differences between ACOG (4.68%) and ISSHP (3.66%) criteria. For eclampsia, the prevalence was 0.43% (95% CI: 0.19%–0.76%), while the estimate for HELLP syndrome is 0.39% (95% CI: 0.16%–0.72%), which must be interpreted with considerable caution as it is…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 9,782,257 participants or records.
Read the paper
Related studies
- Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials
- Tocilizumab in patients with severe COVID-19: a retrospective cohort study
- A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV: A cohort study
- Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study
- Are noise and air pollution related to the incidence of dementia? A cohort study in London, England
- Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.