Transient Gestational Hypertension and Its Subsequent Maternal and Perinatal Outcomes

To describe maternal and perinatal outcomes among pregnant women with transient gestational hypertension (TGH) defined through prolonged in-hospital surveillance.

This retrospective cohort included pregnant women hospitalized at ≥20 weeks of gestation at a referral hospital in Panama between July 1, 2023, and December 31, 2024. Women were included if they had an initial systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, with no subsequent elevated reading during seven days of measurements obtained every four hours; they were then discharged and followed until delivery. The primary outcome was the subsequent development of gestational hypertension or preeclampsia.

A total of 20 pregnant women were included; mean age was 31.9 ± 6.3 years, median gestational age at the initial episode was 32.1 weeks (interquartile range (IQR), 27.9-34.2). Five patients (25.0%; 95% confidence interval, 11.2-46.9) subsequently developed a hypertensive disorder: three developed gestational hypertension and two developed preeclampsia, including one with severe features due to a hypertensive crisis. Among those who progressed, the median time to the new diagnosis was 30 days (IQR, 27-35). Delivery occurred at a median of 38 weeks; there was one preterm delivery, one neonatal intensive care unit admission, and no maternal or perinatal deaths. In exploratory analyses, progression was associated with a higher cesarean delivery rate and lower neonatal birth weight.

Even after seven days of in-hospital normotension, one in four pregnant women progressed to TGH. TGH should not be considered benign and requires subsequent surveillance, ideally with out-of-hospital blood pressure measurements.