Hypertensive Disorders during Pregnancy (HDP), Maternal Characteristics, and Birth Outcomes among Japanese Women: A Hokkaido Study.

Kritika Poudel,Naomi Tamura,Reiko Kishi,Hideyuki Masuda,Kumiko Ito,Chihiro Miyashita,Yu Ait Bamai,Sachiko Itoh,Keiko Yamazaki,Sumitaka Kobayashi,Mariko Itoh,Atsuko Ikeda-Araki

doi:10.3390/ijerph18073342

Abstract

Hypertension during pregnancy causes a greater risk of adverse birth outcomes worldwide; however, formal evidence of hypertensive disorders during pregnancy (HDP) in Japan is limited. We aimed to understand the association between maternal characteristics, HDP, and birth outcomes. In total, 18,833 mother-infant pairs were enrolled in the Hokkaido study on environment and children’s health, Japan, from 2002 to 2013. Medical records were used to identify hypertensive disorders and birth outcomes, namely, small for gestational age (SGA), SGA at full term (term-SGA), preterm birth (PTB), and low birth weight (LBW). The prevalence of HDP was 1.9%. Similarly, the prevalence of SGA, term-SGA, PTB, and LBW were 7.1%, 6.3%, 7.4%, and 10.3%, respectively. The mothers with HDP had increased odds of giving birth to babies with SGA (2.13; 95% Confidence Interval (CI): 1.57, 2.88), PTB (3.48; 95%CI: 2.68, 4.50), LBW (3.57; 95%CI: 2.83, 4.51) than normotensive pregnancy. Elderly pregnancy, low and high body mass index, active and passive smoking exposure, and alcohol consumption were risk factors for different birth outcomes. Therefore, it is crucial for women of reproductive age and their families to be made aware of these risk factors through physician visits, health education, and various community-based health interventions.

Highlights

Pregnancy-induced hypertension (PIH) is defined as hypertension with or without proteinuria (≥300 mg/24 h) emerging after 20 weeks of gestation
hypertensive disorders during pregnancy (HDP) was found to be associated with small for gestational age (SGA) (2.13 our study (OR)), preterm birth (PTB) (3.48 OR), and low birth weight (LBW)
There was no association between term-SGA and HDP in our study

Summary

Introduction

Pregnancy-induced hypertension (PIH) is defined as hypertension (blood pressure≥ 140/90 mmHg) with or without proteinuria (≥300 mg/24 h) emerging after 20 weeks of gestation. Pregnancy-induced hypertension (PIH) is defined as hypertension PIH is defined as a new onset proteinuria (≥300 mg/24 h) in hypertensive women exhibiting no proteinuria before 20 weeks of gestation [1]. In 2004, Japan revised the term “Toxemia of Pregnancy” to “Pregnancy Induced Hypertension,”. Which was further revised in 2017, to “Hypertensive disorders of Pregnancy,” shortly named HDP, which is consistent with the international classification [2]. HDP has been classified into four types as follows: preeclampsia, gestational hypertension, superimposed preeclampsia, and chronic hypertension, excluding eclampsia in the previous disease type classification [3]. HDP occurs in 5% of women and around 10% of primiparous women out of all pregnancies. Primiparity, Body Mass Index (BMI), multiple pregnancies, previous history of HDP, gestational diabetes mellitus, preexisting hypertension, preexisting type 2

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