UPDATING PREVALENCE AND CORRELATES OF HYPERTENSION IN PREGNANCY. CROSS-SECTIONAL ANALYSIS OF 3,648 CONSECUTIVE DELIVERIES IN A TEACHING HOSPITAL IN SPAIN

Abstract

Objective: Hypertension continues to be one of the main medical complications in pregnancy. Our aim was to update prevalence and correlates of this condition. Design and method: Data from 3,648 consecutive deliveries, from January 2016 to December 2017, were analyzed in a tertiary teaching hospital from Spain, following a pre-specified protocol. Definitions of hypertension in pregnancy and hypertension subtypes (gestational hypertension [GH], preeclampsia [PE], chronic hypertension [CH], and chronic hypertension with superimposed preeclampsia [CH+PE]) were those from current international guidelines. Results: Mean age of pregnant women was 33.2 ± 5.4 years. Prevalence of hypertension in pregnancy was 9.4% (95%CI 8.4–10.4). GH (51.8% of hypertensive cases) and PE (41.0%) were the most prevalent forms. CH and CH+PE were present in 5.2% and 1.3% of hypertensive pregnancies. Hypertension prevalence was higher in women aged >40 years (14.5% in women aged 40–45, and 35.3% in women aged >45 years, p < 0.001). Hypertension was also associated to primiparity, shorter gestations (270 vs 277 days), higher cesarean rate (25.6 vs 14.2%), lower birth weight (3,001 vs 3,241 g), and longer admission periods for both mother (5.5 vs 1.9 days) and newborn (4.3 vs 0.8 days), all comparisons p < 0.001. When compared to women with GH, cases with PE showed shorter pregnancies (264 vs 277 days), lower birth weight (2,741 vs 3,187 g), and longer admission periods, all comparisons p < 0.001). No differences were observed between GH cases and normotensive pregnancies with the exception of admission periods which were longer in GH. Conclusions: Prevalence of hypertension in pregnancy in our series was 9.4%. GH and PE were the most common types of hypertension in pregnancy. Hypertension continues complicating pregnancies in terms of gestation duration, birth weight, and days of admission in both the mother and the newborn. These deleterious effects were mainly observed in cases with PE.