Spatiotemporal assessment shows outcomes for preeclampsia/eclampsia in Brazil (2008-2023).

Regional and racial disparities were observed in all macro-regions of Brazil.

Mixed-race women have higher rates of hospitalization and mortality.

The Northeast has a higher number of clusters of mortality due to preeclampsia.

The Southeast has the highest absolute number of cases of preeclampsia.

To analyze the spatiotemporal distribution of preeclampsia and eclampsia in Brazil over 16 years.

Retrospective study (2008–2023) using nationwide SUS data. Women aged 10–49 years with ICD-10 codes O14 and O15 were included.

Hospitalization and maternal mortality rates per 100,000 estimated pregnancies; in-hospital mortality; and Disability-Adjusted Life Years (DALYs). Spatial patterns were assessed using Global Moran’s I and Local Indicators of Spatial Association (LISA), and trends using Joinpoint and Mann–Kendall tests.

Of 877,555 hospitalizations identified, the national rate rose from 38.2 to 86.3 per 1,000 pregnancies (AAPC = 5.7%; p < 0.001). The Northeast had the highest average rate (74.1) and sustained growth. Spatial analysis revealed significant clustering for hospitalization (Moran’s I = 0.565) and mortality (Moran’s I = 0.121), with hotspots in the Northeast and Southeast (Minas Gerais). Eclampsia caused 18.4% of maternal deaths. While national DALY trends were stable, driven by the mortality component (YLL > 99%), the Central-West showed a significant decline (tau =  − 0.55; p = 0.0034). DALY rates were highest in the North (mean = 8.26) and lowest in the South (mean = 3.28).

Preeclampsia/eclampsia hospitalizations are rising in Brazil, yet persistent mortality exposes a quality chasm exacerbated by workforce shortages and SUS underfunding. Addressing these inequities requires strengthening surveillance and referral systems to ensure dignified, high-quality care and reduce the disease burden.

Preeclampsia

Eclampsia

Maternal Mortality

Hospitalization

Spatial Analysis

Brazil

Public Health

© 2026 The Author(s). Published by Elsevier B.V. on behalf of International Society for the Study of Hypertension in Pregnancy.