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Perinatal morbidity in chronic hypertension
L M McCowan1, R G Buist, R A North
1Department of Obstetrics and Gynaecology, National Women's Hospital, Auckland, New Zealand.
British Journal of Obstetrics and Gynaecology
|February 1, 1996
Summary
Women with chronic hypertension face a higher risk of delivering small for gestational age babies. Severe hypertension in early pregnancy significantly elevates risks for both small for gestational age infants and preterm birth.
Area of Science:
- Obstetrics
- Maternal-Fetal Medicine
- Hypertensive Disorders in Pregnancy
Background:
- Chronic hypertension is a common complication in pregnancy.
- Its impact on perinatal outcomes, particularly in the absence of superimposed pre-eclampsia, requires further investigation.
- Understanding these risks is crucial for optimizing maternal and infant care.
Purpose of the Study:
- To determine if chronic hypertension, without superimposed pre-eclampsia, is linked to increased perinatal morbidity.
- Specifically, to compare rates of small for gestational age (SGA) babies and preterm deliveries in women with chronic hypertension versus the general obstetric population.
Main Methods:
- Retrospective cohort study conducted at a tertiary referral obstetric hospital.
- Included 155 pregnant women with chronic hypertension (diastolic blood pressure >90 mmHg before 20 weeks or pre-existing essential hypertension).
- Outcomes assessed included perinatal loss, SGA, preterm delivery, placental abruption, and superimposed pre-eclampsia.
Main Results:
- Women with chronic hypertension (without superimposed pre-eclampsia) had a significantly higher rate of SGA babies (10.9% vs. 4.1%).
- No significant increase in preterm delivery or perinatal loss was observed in this group.
- Severe hypertension (DBP ≥110 mmHg before 20 weeks) was associated with increased risks of SGA, delivery before 32 weeks, and superimposed pre-eclampsia.
Conclusions:
- Chronic hypertension, even without superimposed pre-eclampsia, increases the risk of delivering a small for gestational age baby.
- Severe early-onset hypertension in pregnancy is associated with the greatest perinatal morbidity.
- Superimposed pre-eclampsia is linked to a higher incidence of preterm delivery.