Chronic hypertension and adverse pregnancy outcome: a cohort study
- PMID: 28436175
- DOI: 10.1002/uog.17493
Chronic hypertension and adverse pregnancy outcome: a cohort study
Abstract
Objective: To examine the association between chronic hypertension (CH) and a wide range of adverse pregnancy outcomes after adjustment for confounding factors in obstetric history and maternal characteristics.
Methods: This was a prospective screening study for adverse pregnancy outcomes in women with singleton pregnancy attending their first routine hospital visit at 11 + 0 to 13 + 6 weeks' gestation. Data on maternal characteristics, medical and obstetric history and pregnancy outcome were collected. Regression analysis was performed to examine the association between CH and adverse pregnancy outcomes, including late miscarriage, stillbirth, pre-eclampsia (PE), gestational diabetes mellitus (GDM), spontaneous and iatrogenic preterm birth (PTB), small-for-gestational-age (SGA) neonate, large-for-gestational-age (LGA) neonate and elective and emergency Cesarean section (CS).
Results: The study population of 109 932 pregnancies included 1417 (1.3%) women with CH. After adjusting for potential confounding variables from maternal characteristics, medical and obstetric history, CH was associated with increased risk of stillbirth (odds ratio (OR), 2.38 (95% CI, 1.51-3.75)), PE (OR, 5.76 (95% CI, 4.93-6.73)), SGA (OR, 2.06 (95% CI, 1.79-2.39)), GDM (OR, 1.61 (95% CI, 1.27-2.05)), iatrogenic PTB < 37 weeks (OR, 3.73 (95% CI, 3.07-4.53)) and elective CS (OR, 1.79 (95% CI, 1.52-2.11)), decreased risk of LGA (OR, 0.65 (95% CI, 0.53-0.78)) and had no significant effect on late miscarriage, spontaneous PTB or emergency CS.
Conclusion: CH should be combined with other maternal characteristics and medical and obstetric history when calculating an individualized adjusted risk for adverse pregnancy complications. CH increases the risk of stillbirth, PE, SGA, GDM, iatrogenic PTB and elective CS and reduces the risk for LGA. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
Keywords: Cesarean section; chronic hypertension; gestational diabetes; large-for-gestational age; miscarriage; pre-eclampsia; preterm birth; small-for-gestational age; stillbirth.
Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
Comment in
-
Re: Chronic hypertension and adverse pregnancy outcome: a cohort study. A. M. Panaitescu, A. Syngelaki, N. Prodan, R. Akolekar and K. H. Nicolaides. Ultrasound Obstet Gynecol 2017; 50: 228-235.Ultrasound Obstet Gynecol. 2017 Aug;50(2):155. doi: 10.1002/uog.17554. Ultrasound Obstet Gynecol. 2017. PMID: 28782231 No abstract available.
-
Re: Descriptive analysis of different phenotypes of cardiac remodeling in fetal growth restriction. M. Rodríguez-López, M. Cruz-Lemini, B. Valenzuela-Alcaraz, L. Garcia-Otero, M. Sitges, B. Bijnens, E. Gratacós and F. Crispi. Ultrasound Obstet Gynecol 2017; 50: 207-214.Ultrasound Obstet Gynecol. 2017 Aug;50(2):154. doi: 10.1002/uog.17541. Ultrasound Obstet Gynecol. 2017. PMID: 28782233 No abstract available.
-
Reply.Ultrasound Obstet Gynecol. 2017 Dec;50(6):806-807. doi: 10.1002/uog.18922. Ultrasound Obstet Gynecol. 2017. PMID: 29205579 No abstract available.
-
Alternative explanations for linking chronic hypertension to adverse pregnancy outcome.Ultrasound Obstet Gynecol. 2017 Dec;50(6):805-806. doi: 10.1002/uog.18921. Ultrasound Obstet Gynecol. 2017. PMID: 29205581 No abstract available.
Similar articles
-
Maternal age and adverse pregnancy outcome: a cohort study.Ultrasound Obstet Gynecol. 2013 Dec;42(6):634-43. doi: 10.1002/uog.12494. Ultrasound Obstet Gynecol. 2013. PMID: 23630102
-
Maternal racial origin and adverse pregnancy outcome: a cohort study.Ultrasound Obstet Gynecol. 2013 Mar;41(3):278-85. doi: 10.1002/uog.12313. Ultrasound Obstet Gynecol. 2013. PMID: 23023978
-
Association of chronic hypertension with birth of small-for-gestational-age neonate.Ultrasound Obstet Gynecol. 2017 Sep;50(3):361-366. doi: 10.1002/uog.17553. Epub 2017 Jul 28. Ultrasound Obstet Gynecol. 2017. PMID: 28636133
-
Maternal age ≥45 years and maternal and perinatal outcomes: a review of the evidence.Midwifery. 2013 May;29(5):479-89. doi: 10.1016/j.midw.2012.04.001. Epub 2012 Nov 16. Midwifery. 2013. PMID: 23159159 Review.
-
Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis.J Clin Med. 2021 Feb 9;10(4):667. doi: 10.3390/jcm10040667. J Clin Med. 2021. PMID: 33572322 Free PMC article. Review.
Cited by
-
The influence of occupational noise exposure on blood pressure and hearing loss among female workers of childbearing age.BMC Public Health. 2024 Oct 1;24(1):1489. doi: 10.1186/s12889-024-19004-9. BMC Public Health. 2024. PMID: 39350169 Free PMC article.
-
Evaluation of outcomes and risk factors for recurrent preeclampsia in a subsequent pregnancy.Arch Gynecol Obstet. 2024 Sep 27. doi: 10.1007/s00404-024-07751-4. Online ahead of print. Arch Gynecol Obstet. 2024. PMID: 39331054
-
Neonatal sex and maternal factors associated with small-for-gestational-age neonates: A nationwide population-based study.Health Sci Rep. 2024 Sep 25;7(9):e70093. doi: 10.1002/hsr2.70093. eCollection 2024 Sep. Health Sci Rep. 2024. PMID: 39328978 Free PMC article.
-
Chronic hypertension diagnosed before or during pregnancy and its effects on pregnancy outcomes.J Hum Hypertens. 2024 Aug 22. doi: 10.1038/s41371-024-00944-z. Online ahead of print. J Hum Hypertens. 2024. PMID: 39174670
-
Adverse maternal outcomes and associated factors among mothers of advanced age delivering at a tertiary hospital, southwestern Uganda: a cross-sectional study.BMC Pregnancy Childbirth. 2024 May 7;24(1):348. doi: 10.1186/s12884-024-06557-1. BMC Pregnancy Childbirth. 2024. PMID: 38714930 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical