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Factors Associated with the Severity of the Hypertensive Disorders of Pregnancy: A Cross-Sectional Study

Matthew Shane Loop1, Rachel Peragallo Urrutia2, Jasmine Johnson3

  • 1Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, Alabama, USA.

Journal of Women'S Health (2002)
|October 30, 2025
PubMed

Insights

Hypertensive disorders of pregnancy (HDP) can range in severity. Factors like earlier onset, Hispanic/Latina ethnicity, and gestational diabetes are linked to more severe HDP cases.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Public Health

Background:

  • Hypertensive disorders of pregnancy (HDP) encompass a spectrum of conditions including gestational hypertension, preeclampsia, and eclampsia.
  • Identifying factors contributing to HDP severity is crucial for risk stratification and management.
  • Previous research has not fully established predictors for the progression of HDP.

Purpose of the Study:

  • To identify demographic, clinical, and socioeconomic factors associated with the severity of hypertensive disorders of pregnancy (HDP).
  • To evaluate predictors for developing more severe forms of HDP beyond initial diagnosis.

Main Methods:

  • Retrospective, cross-sectional study utilizing electronic health records from 2014-2017.
  • Analysis of 4,429 women diagnosed with HDP at two academic medical centers.
  • Ordinal logistic regression models were employed to determine odds ratios for HDP severity.

Main Results:

  • Earlier gestational age at HDP onset, Hispanic/Latina ethnicity, non-White race, nulliparity, and gestational diabetes mellitus were associated with increased HDP severity.
  • Higher maternal body mass index and commercial/other insurance were linked to less severe HDP.
  • The majority (83%) of women did not progress to a more severe HDP classification.

Conclusions:

  • Several factors independently predict the severity of hypertensive disorders of pregnancy in a diverse population.
  • Women with identified risk factors may benefit from closer monitoring to improve maternal and fetal outcomes.
  • Further research is warranted to confirm these findings and guide clinical practice for high-risk pregnancies.
Abstract

Keywords:
electronic health recordsordinal logisticpreeclampsiarisk factors

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