Chronic hypertension and the risk for adverse pregnancy outcome after superimposed pre-eclampsia

M. Vanek, E. Sheiner, A. Levy, M. Mazor

    Research output: Contribution to journalArticlepeer-review

    53 Scopus citations

    Abstract

    Objective: To determine the risk factors and pregnancy outcome of patients with chronic hypertension during pregnancy after controlling for superimposed preeclampsia. Method: A comparison of all singleton term (>36 weeks) deliveries occurring between 1988 and 1999, with and without chronic hypertension, was performed. Stratified analyses, using the Mantel-Haenszel technique, and a multiple logistic regression model were performed to control for confounders. Results: Chronic hypertension complicated 1.6% (n=1807) of all deliveries included in the study (n=113156). Using a multivariable analysis, the following factors were found to be independently associated with chronic hypertension: maternal age >40 years (OR=3.1; 95% CI 2.7-3.6), diabetes mellitus (OR=3.6; 95% CI 3.3-4.1), recurrent abortions (OR=1.5; 95% CI 1.3-1.8), infertility treatment (OR=2.9; 95% CI 2.3-3.7), and previous cesarean delivery (CD; OR=1.8 CI 1.6-2.0). After adjustment for superimposed preeclampsia, using the Mantel-Haenszel technique, pregnancies complicated with chronic hypertension had higher rates of CD (OR=2.7; 95% CI 2.4-3.0), intra uterine growth restriction (OR=1.7; 95% CI 1.3-2.2), perinatal mortality (OR=1.6; 95% CI 1.01-2.6) and post-partum hemorrhage (OR=2.2; 95% CI 1.4-3.7). Conclusion: Chronic hypertension is associated with adverse pregnancy outcome, regardless of superimposed preeclampsia.

    Original languageEnglish
    Pages (from-to)7-11
    Number of pages5
    JournalInternational Journal of Gynecology and Obstetrics
    Volume86
    Issue number1
    DOIs
    StatePublished - 1 Jan 2004

    Keywords

    • Chronic hypertension
    • Perinatal mortality
    • Pregnancy outcome
    • Superimposed preeclampsia

    ASJC Scopus subject areas

    • Obstetrics and Gynecology

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