Maternal-fetal outcomes of women with hypertensive disorders of pregnancy

An analytical cross-sectional study was conducted on women admitted with hypertensive disorders of pregnancies to a university maternity hospital from August 2020 to August 2022. Data were collected using a pretested structured questionnaire. Variables associated with adverse maternal and perinatal outcomes were compared using multivariable binomial regression.

RESULTS:

Of 501 women with pregnancies, 2, 35, 14, and 49% had eclampsia, preeclampsia, chronic hypertension, and gestational hypertension, respectively. Women with preeclampsia/eclampsia had significantly higher risks of cesarean section (79.4 vs. 65%; adjusted RR, 2,139; 95%CI, 1,386–3,302; p=0.001) and preterm delivery at <34 weeks’ gestation (20.5 vs. 6%; adjusted RR, 2.5; 95%CI, 1.19–5.25; p=0.01) than those of women with chronic/gestational hypertension. Risks of prolonged maternal hospitalization (43.9 vs. 27.1%), neonatal intensive care unit admission (30.7 vs. 19.8%), and perinatal mortality (23.5 vs. 11.2%) were higher among women with preeclampsia/eclampsia.

CONCLUSIONS:

Women with preeclampsia/eclampsia had a higher risk of adverse maternal and neonatal outcomes than those with chronic or gestational hypertension. This major maternity care center requires strategies for preventing and managing preeclampsia/eclampsia to improve pregnancy outcomes.

KEYWORDS:
Hypertension, pregnancy-induced; Hypertension; Preeclampsia; Eclampsia

Maternal outcomes	Chronic gestational hypertension (n=316) n (%)	Preeclampsia/eclampsia (n=185) n (%)	Crude RR (95%CI)	p-value	Adjusted RR (95% CI)	p-value
Term labor <34 weeks	19 (6.0)	38 (20.5)	4.041 (2.251–7.254)	<0.0001	2.505 (1.194–5.257)	0.015
Term labor >37 weeks	107 (33.9)	96 (51.9)	2.106 (1.454–3.053	<0.0001	1.152 (0.980–2.361)	0.061
Cesarean section^a a Adjusted for the stage of pregnancy at admission.	206 (65.2)	147 (79.4)	2.065 (1.35–3.160)	0.001	2.139 (1.386–3.302)	0.001
Prolonged maternal hospital stay^b b Adjusted for estimated gestational age (EGA) at diagnosis, EGA at delivery, and stage of pregnancy at admission.	159 (50.3)	110 (59.4)	1.448 (1.003–2.091)	0.048	1.126 (0.757–1.677)	0.556

Maternal outcomes	Chronic/gestational hypertension (n=316) n (%)	Preeclampsia/eclampsia (n=185) n (%)	Crude RR (95% CI)	p-value	Adjusted RR (95%CI)	p-value
Prematurity birth<34 weeks	19 (6.0)	38 (20.5)	4.041 (2.251–7.254)	<0.001	2.505 (1.194–5.257)	0.015
Apgar (<7) at 1 min^a a Adjusted for EGA at diagnosis and stage of pregnancy at admission.	28 (8.8)	28 (15.1)	1.835 (1.049–3.207)	0.033	1.967 (1.112–3.477)	0.020
Apgar (<7) at 5 min	8 (2.5)	13 (7.0)	2.909 (1.183–7.159)	0.020	3.683 (1.500–9.356)	0.006
NICU admission	19 (6.0)	42 (22.7)	4.591 (2.577–8.179)	<0.001	2.567 (1.296–5.088)	0.007
Perinatal mortality^b b Adjusted for parity (before delivery), EGA at diagnosis; the number of antenatal visits, and stage of pregnancy at admission.	7 (2.2)	10 (5.4)	2.522 (0.943–6.745)	0.065	0.423 (0.101–1.770)	0.239

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

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[1] *Corresponding author: anakatherineufrnet@gmail.com