Stage 1 Hypertension in Nulliparous Pregnant Patients and Risk of Unplanned Cesarean Delivery

The aim of the study is to determine whether stage 1 hypertension is a risk factor for cesarean at ≥39^0/7 weeks.

This is a retrospective cohort study of nulliparas delivering at ≥39^0/7weeks. Exposure was defined as stage 1 hypertension and compared with normotension. The primary outcome was unplanned cesarean. Statistical analysis was performed using SPSS 27.

Two hundred and fifty patients had stage 1 hypertension and 250 had normotension. Thirty-eight percent of the patients with stage 1 hypertension required cesarean as did 22% of controls (risk ratio [RR]=1.55, 95% confidence interval [CI]: 1.23-1.96, p <0.001). This remained significant after controlling for confounders in a logistic regression (odds ratio [OR]=1.61, 95% confidence interval [CI]: 1.02-2.55, p <0.040). Upon secondary analysis, these results were statistically significant for gestational age ≥39^5/7 weeks (adjusted odds ratio [AOR]=1.89, 95% CI: 1.05-3.39, p=0.033) but not from 39^0/7 to 39^4/7weeks (AOR=0.68, 95% CI: 0.31-1.50, p=0.34).

In nulliparas, stage 1 hypertension is an independent risk factor for unplanned cesarean.

· Stage 1 hypertension correlates with more cesareans.. · Unplanned cesarean for nonreassuring fetal status correlates with impaired placental function.. · Stages 1 and 2 hypertension carry similar risks..