Emergent Acute Hypertension During Pregnancy-Anomaly or Future Trend?

Abstract

Background: Hypertension during pregnancy is a complication that can be life-threatening for the mother/infant dyad. Women who are hypertensive during pregnancy experience higher rates of emergent complications which can lead to induction of labor or, in worst cases, cesarean-section delivery. For the infants, hypertension can cause complications such as intrauterine growth retardation, premature birth, and neonatal mortality. Is the rate of hypertension during pregnancy increasing? Methods: A cohort retrospective chart review was conducted for a 12-month period to identify the number of patients who received a diagnosis of hypertension during pregnancy. Women with documented chronic hypertension were not included in the sample. The Institutional Review Boards for the participating hospital and University approved the study as exempt, using deidentified data. Results:The total number of births for the 12-month period was 2763. The rate of hypertension diagnosed during pregnancy was 19% (n=530). Ethnicity did not correlate with diagnosis of gestational hypertension, but was significant for infant mortality rates. Conclusion:These results have strongly demonstrated that the local rate of gestational hypertension is higher than the rate reported in the medical literature. Over one-third (36%) of the infants of hypertensive women in this study were delivered prematurely. Over one quarter (28%) of the infants were admitted to neonatal intensive care, and the infant mortality was quite high (47 per 1000), disproportionally so for Hispanic and Black infants. Further research could improve prevention strategies to develop healthier outcomes for mothers suffering from gestational hypertension.

Hypertensive Disorders of Pregnancy in a Military Hospital Birth Cohort

“…Data from this study confirm that the incidence of HDP has been increasing. The rate of HDP in this cohort was 18.3%, which was similar to the 19% rate reported for East Texas, 30 but higher than the rates reported for other states. 36 It has been reported in the international medical literature that the incidence of HDP has increased by up to 10.92% between 1990 and 2019.…”

“…Although higher than the Center for Disease Control and Prevention (CDC) statistics reported in 2018, the rates in this study are lower than have been reported recently. 30 …”