Impact of Hypertensive Disorders of Pregnancy on Stillbirth and Other Perinatal Outcomes: A Multi-Center Retrospective Study.

Marina Basta,Umar Ghaffar,Kiran Hanif,Sana Zafar,Sher Wali,Faiqa Amin,Sabeen Sharif Khan,Fares Mohammed Saeed Muthanna,Abdalla Khabazeh

doi:10.7759/cureus.22788

Abstract

Objective: The aim of the study is to assess the impact of hypertensive disorders of pregnancy on stillbirths and other perinatal outcomes among women in Karachi, Pakistan.Methodology: This was a retrospective cohort study conducted at two tertiary care hospitals, Aga Khan Hospital (AKU) and Liaquat National Hospital (LNH) in Karachi, Pakistan. The primary outcome variable of this study was stillbirth. Other outcomes assessed in this study included preterm birth, low birth weight, and early neonatal death.Results: Data of a total of 840 women were included in this study; 280 (33.33%) women had hypertensive disorders of pregnancy and 560 (66.67%) were normotensive. Among women who had hypertensive disorders of pregnancy, the adjusted odds ratio (AOR) of having a stillbirth was two times more than that for normotensive women (AOR=2.62, 95% CI=1.46-4.40), four times for low birth weight (AOR=4.23, 95% CI=2.88-6.20), five times for early neonatal death (AOR=5.03, 95% CI=2.40-10.50) and six times for pre-term birth (AOR=5.16, 95% CI=3.42-7.79).Conclusion: The current study found that incidence of stillbirth, low birth weight, pre-term birth, and neonatal mortality is higher in mothers with hypertensive disorders of pregnancy than normotensive mothers.

Highlights

Stillbirths are a major global issue that has gotten little attention
Among women who had hypertensive disorders of pregnancy, the adjusted odds ratio (AOR) of having a stillbirth was two times more than that for normotensive women (AOR=2.62, 95% CI=1.46-4.40), four times for low birth weight (AOR=4.23, 95% CI=2.88-6.20), five times for early neonatal death (AOR=5.03, 95% CI=2.40-10.50) and six times for pre-term birth (AOR=5.16, 95% CI=3.42-7.79)
The current study found that incidence of stillbirth, low birth weight, pre-term birth, and neonatal mortality is higher in mothers with hypertensive disorders of pregnancy than normotensive mothers

Summary

Introduction

Stillbirths are a major global issue that has gotten little attention. Each year, an estimated 2.6 million babies are stillborn, with 98% of them taking place in low and middle-income nations [1]. Stillbirths are known to be linked to pregnancy complications, and hypertensive disorders of pregnancy (HDP) are the most common cause of pregnancy complications [2]. Disorders such as gestational hypertension, pre-eclampsia or eclampsia, superimposed preeclampsia and chronic hypertension occur in 3-8% of pregnancies all over the world [3]. These four subgroups are thought to play various roles in stillbirth due to their diverse pathogenic processes and clinical symptoms [4]. They are an important cause of perinatal and maternal morbidity [5]

Methods

Results

Conclusion