Key result
Superimposed pre-eclampsia affects ~40% of women with pre-existing hypertension, driving the worst pregnancy outcomes.
Why the study?
There have been conflicting reports about pregnancy outcomes in hypertensive disorders of pregnancy, necessitating examination using a population database.
Do hypertensive disorders of pregnancy worsen pregnancy outcomes compared to normotensive pregnancies?
Population
70,386 singleton pregnancies in South Australia from 1998-2001 including hypertensive and normotensive women
Comparison
Pre-existing hypertension, pregnancy hypertension, and superimposed pre-eclampsia versus normotensive pregnancies
Design
Population-based cohort study using perinatal data collection
Follow-up
Perinatal period
Authors
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Hypertensive disorders link to higher preterm birth and NICU admission; leaves open whether modern care has equalized perinatal mortality.
Cohort (n=70,386)
Do hypertensive disorders of pregnancy worsen pregnancy outcomes compared to normotensive pregnancies?
While hypertensive disorders of pregnancy are associated with high levels of morbidity and intervention, perinatal mortality has fallen to levels equivalent to normotensive pregnancies.
Heard et al. (2004) conducted a cohort in Hypertensive disorders of pregnancy (n=70,386). Hypertensive disorders of pregnancy vs. Normotensive pregnancies was evaluated on Pregnancy outcomes including birthweight, gestational age, length of stay, and perinatal deaths. Hypertensive disorders of pregnancy increased morbidity risks, with superimposed pre-eclampsia occurring in ~40% of women with pre-existing hypertension and having the most severe outcomes.
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