Perinatal Mortality Due to Pre-Eclampsia in Africa: A Comprehensive and Integrated Approach Is Needed

In a recent Global Health: Science and Practice editorial, Hodgins identified key steps to ‘‘take a big chunk out of the wedge of maternal, newborn, and stillbirth mortality attributable to eclampsia/pre-eclampsia,’’ calling for early case identification with more frequent antenatal care (ANC) contacts, effective management of complications in pregnant women that progress to life-threatening states, and timely delivery. The editorial is an important call to action and we agree with its proposals; however, there are complementary programmatic issues that must also be considered in crafting an integrated strategy for addressing the burden of perinatal morbidity and mortality attributable to hypertensive disorders in pregnancy in Africa. These include: (a) strengthening management of preterm neonates, (b) strengthening delivery of secondary prevention through ANC, and (c) integrating primary prevention into ANC delivery.