Abstract
Objectives
To examine the prevalence, etiology, and clinical outcomes of secondary hypertension in pregnancy in a high-risk tertiary care hospital.
Study Design
This retrospective study used data from patient records between January 2015 and July 2018. Of 52,293 pregnant women admitted during this period, those with hypertension were included. Patient demographics, diagnosis of secondary hypertension, investigations, suspected etiologies of secondary hypertension, maternal and neonatal outcomes and discharge conditions were included.
Main Outcome Measures
The prevalence of secondary hypertension and causes were measured. Univariate followed by multivariate analyses were done to look for associated maternal and neonatal outcomes.
Results
Among patients with chronic hypertension in pregnancy, 13.7% had secondary causes, of which renal and cardiac causes were the commonest. The incidence of severe pre-eclampsia (40.5%) among patients with secondary hypertension was higher in patients with systolic blood pressures more than 140 mm of Hg than in those with systolic blood pressures lower than 140 mm of Hg (odds ratio [OR]: 4.92, confidence interval [CI]: 1.7–14.16, p: 0.002) irrespective of etiology. Pre-eclampsia predisposed to maternal acute kidney injury (OR: 1.23, CI: 1.04–1.45, p: 0.003), low birthweight (OR: 4.69, CI: 1.44–11.9, p: 0.006), preterm delivery (OR: 4.69, CI: 1.78–12.34, p: 0.001), and neonatal death (OR: 5.19, CI: 0.97–27.6, p: 0.04).
Conclusion
The prevalence of hypertension in pregnancy was 10.3%; among them, the prevalence of secondary hypertension was 1.46%. Uncontrolled secondary hypertension was associated with poor maternal and neonatal outcomes. Strict control of blood pressure in secondary hypertension in pregnancy ensured better outcomes.
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Abbreviations
- AHA:
-
American heart association
- SPSS:
-
Statistical product and service solutions
- OR:
-
Odds ratio
- CI:
-
Confidence interval
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Acknowledgments
Ann Helen Prasad for editorial support.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Audrin Lenin conceptualized, designed the study, and did the literature review, data collection, Data analysis and manuscript preparation, editing and manuscript review. Reeta Vijayselvi conceptualized, designed the study, logistic support, manuscript editing and manuscript review. Sudha Jasmine Rajan conceptualized, designed the study, did data analysis, interpretation and manuscript editing and manuscript review. Swati Rathore logistic support, manuscript editing and manuscript review. Kavitha Abraham conceptualized, designed the study logistic support, manuscript editing and manuscript review. Bijesh Yadav data analysis, manuscript editing and manuscript review. Sowmya Sathyendra conceptualized, designed the study and manuscript editing and manuscript review.
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Ethical Approval
IRB approval IRB Min. No. 13525 [Retro] dated 28.10.2020.
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Informed consent was not sought for the present study because data were extracted from the hospital electronic database.
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Dr. Audrin Lenin, Assistant professor, Department of Medicine unit 3 and Obstetric Medicine, Christian Medical College, Vellore, Tamil Nadu, 632004, India. Dr. Reeta Vijayaselvi, Professor, Department of Obstetrics unit 4, Christian Medical College, Vellore, Tamil Nadu, 632004, India. Dr. Sudha Jasmine Rajan, Professor, Department of Medicine unit 3 and Obstetric Medicine, Christian Medical College, Vellore, Tamil Nadu, 632004, India. Dr. Swati Rathore, Professor, Department of Obstetrics unit 5, Christian Medical College, Vellore, Tamil Nadu, 632004, India. Dr. Kavitha Abraham at Department of Obstetrics unit 3, Christian Medical College, Vellore, Tamil Nadu, 632004, India. Mr. Bijesh Yadav, Statistician, Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, 632002, India. Dr. Sowmya Satyendra, Professor and head, Department of Medicine unit 3 and Obstetric Medicine, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
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Lenin, A., Vijayaselvi, R., Rajan, S.J. et al. The Impact of Secondary Hypertension in Pregnancy on Maternal and Fetal Outcomes: A 42-Month Observational Study from South India. J Obstet Gynecol India 72 (Suppl 1), 139–145 (2022). https://doi.org/10.1007/s13224-021-01576-w
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DOI: https://doi.org/10.1007/s13224-021-01576-w