Abstract
BackgroundThe impact of anti-hypertensive treatment on fetus was unclear, and hence, remains controversial. We set out in this study to estimate the prevalence of adverse pregnancy outcomes, including low birth weight, preterm delivery and small for gestational age amongst women with chronic hypertension, and to determine whether the use of anti-hypertensive drugs increases the risk of such adverse pregnancy outcomes.Methodology/Principal FindingsA total of 2,727 hypertension mothers and 8,181 matched controls were identified from the population-based cohort. These hypertension women were divided into seven sub-groups according to different types of prescribed anti-hypertensive drugs. Multivariable logistic regressions were conducted to estimate the risk of low birth weight, preterm birth and small for gestational age. Increased risk of low birth weight (OR = 2.29, 95% CI = 1.95–2.68), preterm birth (OR = 2.18, 95% CI = 1.89–2.52) and small for gestational age (OR = 1.62, 95% CI = 1.45–1.81) were all discernible within the hypertension group after adjusting for potential confounding factors. The increased ORs were found to differ with different types of anti-hypertensive drugs. Women who received vasodilators were associated with the highest risk of low birth weight (OR = 2.96, 95% CI = 2.06–4.26), preterm birth (OR = 2.92 95% CI = 2.06–4.15) and small for gestational age (OR = 2.12, 95% CI = 1.60–2.82).Conclusions/SignificanceThis finding is important for practitioners, because it indicates the need for caution while considering the administration of anti-hypertensive drugs to pregnant women. These observations require confirmation in further studies that can better adjust for the severity of the underlying HTN.
Highlights
Chronic hypertension, which is found to occur in approximately one to three per cent of all pregnancies, is one of the leading causes of maternal mortality [1,2,3]
The maternal and infant characteristics of the HTN group and the age-matched comparison group are compared in Table 1; HTN mothers were more likely to have a diagnosis of diabetes, anemia, coronary heart disease and hyperlipidemia (p,0.001)
The population-based cohort adopted for this study revealed that infants born to women with chronic HTN were at an increased risk of LBW, preterm birth and SGA
Summary
Chronic hypertension, which is found to occur in approximately one to three per cent of all pregnancies, is one of the leading causes of maternal mortality [1,2,3]. Anti-hypertensive treatment has been proven to prevent, or delay, the occurrence of serious complications during pregnancy. It was reported in a recent Cochrane review that anti-hypertensive treatment reduces the risk of developing severe hypertension and is beneficial to pregnant women. The review concluded by pointing out that the impact of anti-hypertensive treatment on babies was still unclear [4], and remains controversial. We set out in this study to estimate the prevalence of adverse pregnancy outcomes, including low birth weight, preterm delivery and small for gestational age amongst women with chronic hypertension, and to determine whether the use of antihypertensive drugs increases the risk of such adverse pregnancy outcomes
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