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Objective: Arterial hypertension affects about 5-10% of pregnancies and has detrimental effects on pregnancy outcomes in both the mother and fetus. The study aimed to analyse the outcomes of pregnancy in women with untreated and treated arterial hypertension in pregnancy in the Czech Republic during the past decade. Design and method: Nationwide data on all births and abortions in the period 2012-2022 in the Czech Republic were obtained from the National Registry of Reproductive Health (NRRZ) and the National Registry of Reimbursable Health Services (NRHZS). Women who had the diagnosis I10 within one year before pregnancy and were prescribed any antihypertensive drug from selected ATC groups (C02, C03, C07, C08, C09) were classified as pre-existing hypertension. Women diagnosed with O13 or I10 during pregnancy were classified as pregnancy induced hypertension. Hypoxia in the new-born was defined as pH <7.1 or Apgar score <8 present after delivery. We used descriptive statistics to evaluate the outcomes. Results: There were total of 1,154,648 deliveries in the 11-year period. The proportion of women with hypertension in pregnancy was 8.24% and their mean age was 31±5 years. Mean age of women without hypertension was 30±5 years. 77,121 women (77.9%) had untreated hypertension, 21,094 (22.1%) women were treated with antihypertensive drugs during pregnancy. Women with treated hypertension (TH) had higher proportion of delivery by Caesarean section (43.8%) compared to women with untreated hypertension (UTH; 34.3%) and women without hypertension (NH; 23.9%). Women with TH and UTH also had higher proportion of pre-term deliveries in earlier gestational ages (please see the Table). Hypoxia in the new-born occurred in 10.6% women without hypertension, in 13.0% with UTH and 14.8% with TH. Conclusions: Women who require antihypertensive treatment during pregnancy have worse pregnancy outcomes than women with untreated hypertension and women without hypertension in pregnancy. The necessity of pharmacological treatment may be a proxy of more severe hypertension.
Jan et al. (Wed,) studied this question.