Perinatal Outcome in Pregnancies Associated with Hypertension: A Prospective Cohort Study in a Rural Tertiary Care Teaching Hospital of North India.

objectiveThe objective of the study is to know type of hypertension affecting pregnant women and impact on perinatal outcome. SUBJECT AND

methodsThis is a prospective cohort study; 120 women with hypertensive disorders of pregnancy (HDP) at gestation ≥28 weeks who delivered in our institute were enrolled. Sociodemography, gestational age, mode of delivery, APGAR, birth weight, fetal growth restriction (FGR), and perinatal outcome were recorded. Mean ± standard deviation or proportions, analysis of variance, Chi-square test, and odds ratio were used for statistical analysis.

resultsPreeclampsia (PE) was most prevalent hypertensive disorder of pregnancy (44.2%), followed by eclampsia (27.50%), gestational hypertension (23.3%), and chronic hypertension (CH) (5.0%). In PE group, 61.8% had FGR, 65.5% newborns were preterm, 74.6% had low birth weight, and 54.1% needed neonatal intensive care unit (NICU) admission. In eclampsia group, 42.9% had fetal growth restriction, 65.7% preterm, 80% low birth weight, and 78.6% NICU admission. PE women delivered more fetal growth-restricted babies with odd ratio of 2.37 (95% confidence interval [CI]: 1.15, 4.9) and at lower gestation with odd ratio of 2.00 (95% CI: 0.95, 4.21). Eclampsia group had more newborn with low APGAR 1 min, NICU admissions, and those requiring ventilator with odds ratio of 3.10 (95% CI: 1.37, 7.03), 4.48 (95% CI: 1.64, 12.24), and 4.09 (95% CI: 1.6, 10.46), respectively. Perinatal mortality was 10, 9, and 2 in eclampsia, PE, and gestational hypertension groups, respectively, with overall rate of 16.9%. PE and eclampsia comprised 71.70% of HDP but contributed 90.5% of all perinatal deaths.

conclusionPreeclampsia-eclampsia is associated with increased risk of adverse perinatal outcomes as compared to gestational and CH, necessitating screening, vigilant antenatal care, timely intervention, and referral.