Factors Associated with Maternal Morbidity in Patients with Eclampsia in Three Obstetric Intensive Care Units: A Retrospective Study

<b>(1) Introduction</b>. Eclampsia is a rare complication that can occur during pregnancy and has a significant impact on maternal and neonatal outcomes. The aim of this study was to investigate the risk factors associated with significant maternal morbidity after an eclamptic seizure. <b>(2) Methods.</b> An observational retrospective study was performed in three maternity hospitals in Romania between 2015 and 2023 and included pregnant patients diagnosed with eclampsia. Clinical and paraclinical data were investigated, and the impact of several risk factors was assessed using multiple logistic regression analysis. The results were reported as risk ratios (RRs) and 95% confidence intervals (Cis). <b>(3) Results.</b> A total of 104 patients with preeclampsia, of whom 23 experienced eclamptic seizures, were included in this study. A total of 82.6% of the patients diagnosed with eclampsia experienced a form of significant morbidity (stroke, PRES syndrome, or any organ failure/dysfunction). Our regression analysis revealed that advanced maternal age (RR: 12.24 95% CI: 4.29-36.61, <i>p</i> = 0.002), the presence of thrombotic disorders (RR: 9.17, 95% CI: 3.41-23.70, <i>p</i> = 0.03), obesity (RR: 4.89, 95% CI: 0.78-18.15, <i>p</i> = 0.036), and smoking status (RR: 2.18, 95% CI: 0.13- 6.51, <i>p</i> = 0.042) significantly increase the risk of maternal comorbidities. <b>(4) Conclusions.</b> Careful monitoring of pregnant patients, adequate weight control during pregnancy, and correct anticoagulation of individual patients could reduce the extent of postpartum comorbidities that can result from an eclamptic seizure.