Small for Gestational Age in Women With Different Degrees of Chronic Hypertensive Disease [25C

Abstract

INTRODUCTION: To evaluate the risk of small for gestational age (SGA) in women with chronic hypertension (CHTN) classified by severity of hypertension. METHODS: Retrospective cohort of women with CHTN that delivered at Thomas Jefferson University Hospital from January 2008 to June 2016. Women diagnosed with CHTN before pregnancy or during first 20 weeks of gestation, were classified in 3 groups: no antihypertensive medications, severe hypertension requiring antihypertensive medications or CHTN associated with renal disease. Primary outcome was incidence of SGA. Secondary outcomes were superimposed preeclampsia and preterm delivery (PTD). RESULTS: We identified 334 women with CHTN without medications, 210 women with severe CHTN requiring medication and 40 women with CHTN and renal disease. Maternal demographics and other comorbidities were not significantly different among the 3 groups. SGA less than 10th% was significantly increased in CHTN requiring medication [odds ratio (OR) 2.1 95% confidence interval (CI) 1.3-3.3] and CHTN and renal disease [OR 2.6 95% CI 1.2-5.8] when compared CHTN without medications. PTD less than 34 weeks was significantly increased in CHTN requiring medication [OR 1.6 95% CI 1.0-2.7] and CHTN and renal disease [OR 3.8 95%CI 1.8-7.9] when compared to CHTN without medications. Superimposed preeclampsia with severe features was increased in CHTN and renal disease [OR 2.0 95%CI 1.1-4.1] when compared to CHTN without medications. CONCLUSION: Women with severe CHTN requiring medications and CHTN with renal disease had increased risk of SGA, PTD and superimposed preeclampsia with severe features when compared with CHTN without medications.