Abstract
Background: Eclampsia remains a major contributor to maternal mortality globally, particularly in resource-limited settings. While environmental factors have been implicated in pregnancy complications, evidence linking ambient temperature and humidity to eclampsia incidence in South Asian populations remains limited. This study investigates seasonal patterns of eclampsia and their association with meteorological variables in northwestern Pakistan.
Methods: We conducted a prospective observational study at Women & Children Hospital, Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan, from January 2022 to December 2024. All eclampsia cases (n=102) were systematically documented using standardized protocols. Concurrent meteorological data (temperature, humidity) were obtained from regional weather stations. Statistical analyses included chi-square tests for seasonal distribution, Pearson correlation for temperature-humidity associations, and comparative analyses between seasonal groups.
Results: Among 102 eclampsia cases, 67 (65.7%) occurred during winter months (November-February), representing a 3.3-fold higher incidence compared to summer months (8 cases, 7.8%; p<0.001). Winter months were characterized by significantly lower temperatures (14.7±2.1°C vs. 32.5±1.2°C in summer; p<0.001) and higher humidity (68.8±4.3% vs. 43.7±5.8%; p<0.001). Strong inverse correlation existed between monthly temperature and eclampsia incidence (r=-0.782, p<0.001), with positive correlation between humidity and incidence (r=+0.694, p<0.001). Primigravid women comprised 74.5% of cases. The case fatality rate was 6.9%, with acute kidney injury (14.7%) and HELLP syndrome (11.8%) being the most common complications. Clinical severity and outcomes showed no significant differences between winter and summer cases.
Conclusion: This study highlights distinct seasonal patterns in eclampsia in northwestern Pakistan, with peak incidence during cooler, humid winter months. These findings suggest environmental influences on the timing of eclampsia and support the implementation of season-specific surveillance and preventive strategies in similar climatic regions.