Maternal and Systemic Outcomes of Hypertensive Disorders of Pregnancy: A Cross-Sectional Study

Background: Hypertensive disorders of pregnancy are a major cause of maternal and perinatal morbidity and mortality, particularly in low-resource settings, due to delayed diagnosis and inadequate antenatal care. Objectives: To assess maternal systemic manifestations, fetal/neonatal outcomes, and predictors of adverse outcomes among women with hypertensive disorders of pregnancy. Methods: A hospital-based cross-sectional study was conducted on 200 pregnant women (≥20 weeks gestation) with hypertensive disorders of pregnancy at Um Al-Baneen Private Hospital, Baghdad, during 2025. Data on demographic, clinical, laboratory parameters, and maternal and neonatal outcomes were collected. Logistic regression analysis was performed to identify predictors of adverse outcomes. Results: The mean age was 28.3 ± 6.1 years; 28.5% were ≥35 years and 31.5% had no antenatal care. Preeclampsia was the most common subtype (39%), followed by gestational hypertension (26%) and severe preeclampsia (24.5%). Severe hypertension was present in 33.5%, proteinuria in 44%, thrombocytopenia in 17%, elevated liver enzymes in 20.5%, and renal impairment in 14.5%. Systemic complications included hepatic dysfunction (15.5%), ICU admission (13.5%), acute kidney injury (11.5%), and HELLP syndrome (9.5%). Cesarean section was performed in 60.5%, and maternal mortality was 1%. Neonatal outcomes included low birth weight (37%), preterm delivery (34.5%), NICU admission (29%), and low Apgar score (18%). Significant predictors of adverse outcomes included severe hypertension, thrombocytopenia, elevated creatinine, elevated liver enzymes, advanced maternal age, anemia, and inadequate antenatal care (p<0.05). Conclusion: Hypertensive disorders of pregnancy, particularly severe preeclampsia, is associated with substantial maternal and neonatal morbidity. Early detection, adequate antenatal care, and timely management of high-risk cases are essential to improve outcomes.