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Hypertensive disorders of pregnancy and the small for gestational age neonate: not a simple relationship

Sorina Grisaru-Granovsky1, Tamar Halevy, Arthur Eidelman

  • 1Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel.

American Journal of Obstetrics and Gynecology
|April 4, 2007
PubMed

Insights

Hypertensive disorders in pregnancy do not correlate with small for gestational age (SGA) babies as a measure of hypertension severity. Instead, SGA reflects fetal susceptibility to growth factors or familial growth patterns.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Perinatology

Background:

  • Hypertensive disorders of pregnancy are common and can lead to adverse outcomes.
  • Intrauterine growth restriction (IUGR), often identified by small for gestational age (SGA) status, is frequently associated with hypertensive disorders.
  • The relationship between hypertensive disorders and IUGR/SGA has been considered an indicator of hypertensive disease severity.

Purpose of the Study:

  • To investigate the correlation between hypertensive disorders of pregnancy and SGA.
  • To determine if SGA reflects the severity of hypertension in pregnant individuals.
  • To explore potential common pathophysiological pathways.

Main Methods:

  • Retrospective review of perinatal and hospital data from 1998-2002.
  • Identification of women with singleton pregnancies and hypertensive disorders.
  • Comparison of women with SGA babies versus those with appropriate for gestational age babies.

Main Results:

  • No significant difference in the severity characteristics of hypertensive disorders was observed between the SGA and appropriate for gestational age groups.
  • Mothers of SGA babies had a higher incidence of a previous SGA baby compared to mothers of appropriate for gestational age babies.
  • No difference in the incidence of previous hypertension was found between the groups.

Conclusions:

  • Intrauterine growth restriction (IUGR) in the context of hypertensive disorders of pregnancy is not a reliable measure of hypertension severity.
  • IUGR/SGA likely reflects underlying fetal susceptibility to growth factors or unique familial growth patterns.
  • The utility of IUGR as a gauge for hypertensive disorder severity warrants reassessment.
Abstract

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