Neonatal outcome in hypertensive disorders of pregnancy in tertiary care centre

Abstract

Hypertensive disorders of pregnancy, contribute to significant neonatal mortality and morbidity, with complications ranging from prematurity, low birth weight and respiratory morbidities.This study is a observational study done in tertiary care hospital in Cuttack, Odisha during the period December 2018 to November 2020. Mothers, aged 18 to 36 years, beyond 20 weeks of pregnancy with hypertensive disorders complicating pregnancy admitted, with booked pregnancy and regular antenatal check-up were included in the study. Those with underlying chronic diseases like chronic diabetes mellitus, chronic renal failure, chronic hypertension, heart disease, twin or multiple pregnancy and polyhydramnios were excluded. The neonates born followed and outcomes noted. Data analysed using SPSS 26 and results expressed in percentage and comparison across the groups done using Chi Square test / Fisher's Exact Test as appropriate.: Among 150 mothers, majority were suffering from severe preeclampsia (36%) followed by gestational hypertension (27.3%), with most (66.7%) being a term pregnancy. 20.9% were stillbirths and 34% needed NICU admission for various complications. The most common neonatal complication noted was intrauterine growth retardation. A significant association noted between the severity of hypertension and maturity (p<0.001), birth weight (p=0.001), delivery outcome (p=0.001) and neonatal complications (p=0.009). The delivery outcome, gestational age and birth weight, along with neonatal complications had a significant association with increasing severity of the hypertension. Thus, there is urgent necessity for strict protocols to screen, early detection and efficient management of these disorders in pregnant women, in order to ensure a safe outcome for both mother and newborn.