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Chronic hypertension and adverse pregnancy outcome: a cohort study
Author(s) -
Panaitescu A. M.,
Syngelaki A.,
Prodan N.,
Akolekar R.,
Nicolaides K. H.
Publication year - 2017
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.17493
Subject(s) - medicine , obstetrics , pregnancy , miscarriage , gestational diabetes , odds ratio , small for gestational age , cohort study , gestation , gestational hypertension , gestational age , population , prospective cohort study , gynecology , genetics , environmental health , biology
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.