Lisonkova S, Razaz N, Sabr Y, et al. - Researchers conducted a retrospective population‐based cohort study investigating the incidence, risk factors and adverse birth outcomes linked with elevated liver enzymes and low platelets (HELLP) syndrome. From 2012/13 to 2015/16, 1,078,323 mothers with a singleton hospital live birth or stillbirth at ≥ 24 weeks gestation in Canada (excluding Quebec) were assessed. Using ICD‐10‐CA diagnostic code, HELLP syndrome was identified to have incidence of 2.5 per 1,000 singleton deliveries (n = 2,663). Following were the associated risk factors: age ≥ 35 years, rural residence, nulliparity, parity ≥ 4, prepregnancy and gestational hypertension and diabetes, assisted reproduction, chronic cardiac conditions, systemic lupus erythematosus, obesity, chronic hepatic conditions, placental disorders (eg, fetomaternal transfusion), and congenital anomalies. There appeared an inverse association of PROM and age < 25 years with HELLP syndrome. Outcomes revealed association of HELLP syndrome with higher rates of maternal death, and substantially higher severe maternal morbidity, perinatal mortality and severe neonatal morbidity.