Perinatal Outcome in Women with Hypertensive Disorders of Pregnancy in Rural Tertiary Center of Northern India: A Retrospective Cohort Study”

Author(s): Naina Kumar*, Ashu Yadav

Journal Name: Current Pediatric Reviews

Volume 16 , Issue 1 , 2020

Become EABM
Become Reviewer

Graphical Abstract:


Background: Hypertensive disorder of pregnancy is associated with adverse maternal, perinatal outcome.

Objective: To know the perinatal outcome in women with hypertensive disorders of pregnancy.

Methods: Present retrospective cohort study was conducted in the Obstetrics and Gynecology department of the rural tertiary center of Northern India over one year (January-December 2018) on 205 antenatal women with hypertensive disorders of pregnancy at gestation ≥28 weeks. All the participants on the basis of diagnosis were divided into four groups: Group 1 Gestational hypertension; Group 2 Pre-eclampsia; Group 3 Eclampsia and Group 4 with Chronic Hypertension. Demographic features, gestational age, the onset of labor, mode of delivery and perinatal outcome including birthweight, Apgar scores, morbidity and mortality were recorded and compared between four groups. Statistical analysis was done using software SPSS 22.0. version.

Results: Of 205 participants, 93 had Gestational Hypertension, 68 Pre-eclampsia; 36 Eclampsia, 06 Chronic Hypertension. The mean age of presentation was 24.96±3.535 years. Average gestation at birth for group 1 was 37.91±2.38 weeks, group 2: 36.50±3.312 weeks, group 3: 34.44±4.062 weeks and group 4: 37.97±1.524 weeks. The majority of participants had induced labor especially in preeclampsia and eclampsia groups with a spontaneous vaginal delivery as the most common mode. 1 and 5-minute Apgar scores, birth weight were lower in eclampsia and pre-eclampsia women. Severe disease was associated with the adverse perinatal outcome with maximum neonatal morbidity and mortality in eclampsia and pre-eclampsia group.

Conclusion: Hence, hypertensive disorder of pregnancy was associated with adverse perinatal outcome, especially in women with severe disease (Eclampsia and Pre-eclampsia).

Keywords: Birthweight, hypertension, gestation, perinatal, pregnancy, neonate.

Berhe AK, Kassa GM, Fekadu GA, Muche AA. Prevalence of hypertensive disorders of pregnancy in Ethiopia: a systemic review and meta-analysis. BMC Pregnancy Childbirth 2018; 18(1): 34.
Poon LC, Shennan A, Hyett JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet 2019; 145(Suppl. 1): 1-33.
[] [PMID: 31111484]
Kuklina EV, Ayala C, Callaghan WM. Hypertensive disorders and severe obstetric morbidity in the United States. Obstet Gynecol 2009; 113(6): 1299-306.
[] [PMID: 19461426]
Upadya M, Rao ST. Hypertensive disorders in pregnancy. Indian J Anaesth 2018; 62(9): 675-81.
[] [PMID: 30237592]
Umesawa M, Kobashi G. Epidemiology of hypertensive disorders in pregnancy: prevalence, risk factors, predictors and prognosis. Hypertens Res 2017; 40(3): 213-20.
Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384(9947): 980-1004.[Erratum in: Lancet. 2014 Sep 13;384]. [9947]. [:956. PubMed PMID: 24797575; PubMed Central PMCID: PMC4255481].
[] [PMID: 24797575]
Lotufo FA, Parpinelli MA, Haddad SM, Surita FG, Cecatti JG. Applying the new concept of maternal near-miss in an intensive care unit. Clinics (São Paulo) 2012; 67(3): 225-30.
[] [PMID: 22473402]
Naderi T, Foroodnia S, Omidi S, Samadani F, Nakhaee N. Incidence and correlates of maternal near miss in southeast iran. Int J Reprod Med 2015; 2015 914713
[] [PMID: 25763409]
Susannah B, Leisher H, Lawn JE, Kinney MV, Kuo NT, De Bernis L. Stillbirths: Investment in ending preventable stillbirths by 2030 will yield multiple returns and help achieve multiple Sustainable Development Goals. Lancet 2016.
von Dadelszen P, Magee LA. Preventing deaths due to the hypertensive disorders of pregnancy Best Pract Res Clin Obstet Gynaecol 2016; 36: 83.102.
Souza JP, Gülmezoglu AM, Carroli G, Lumbiganon P, Qureshi Z. The world health organization multicountry survey on maternal and newborn health: study protocol. BMC Health Serv Res 2011; 11(1): 286.
[] [PMID: 22029735]
American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy Obstet Gynecol 2013; 122(5): 1122-31.
[] [PMID: 24150027]
Xiong T, Mu Y, Liang J, et al. Hypertensive disorders in pregnancy and stillbirth rates: a facility-based study in China. Bull World Health Organ 2018; 96(8): 531-9.
[] [PMID: 30104793]
NICE clinical guideline 107. Hypertension in pregnancy: The management of hypertensive disorders during pregnancy [Internet Issued: August 2010; last modified: January 2011; Cited 2014 January 16] Available from: 50418/50418.pdf
Asseffa NA, Demissie BW. Perinatal outcomes of hypertensive disorders in pregnancy at a referral hospital, Southern Ethiopia. PLoS One 2019; 14(2)e0213240
[] [PMID: 30817780]
Saxena N, Bava AM, Nandanwar Y. Maternal and perinatal outcome in severe preeclampsia and eclampsia. Int J Reprod Contracept Obstet Gynecol 2016; 5: 2171-6.
Adu-Bonsaffoh K, Ntumy MY, Obed SA, Seffah JD. Perinatal outcomes of hypertensive disorders in pregnancy at a tertiary hospital in Ghana. BMC Pregnancy Childbirth 2017; 17(1): 388.
[] [PMID: 29157196]
Fatemeh T, Marziyeh G, Nayereh G, Anahita G, Samira T. Maternal and perinatal outcome in nulliparious women complicated with pregnancy hypertension. J Pak Med Assoc 2010; 60(9): 707-10.
[PMID: 21381572]
Wolde Z, Segni H, Woldie M. Hypertensive disorders of pregnancy in jimma university specialized hospital. Ethiop J Health Sci 2011; 21(3): 147-54.
[PMID: 22434994]
Vats K, Paul M. Study of fetal outcome in hypertensive disorders of pregnancy in a tertiary care maternity hospital of Delhi. Int J Reprod Contracept Obstet Gynecol 2016; 5: 3773-7.
Langenveld J, Ravelli ACJ, van Kaam AH, et al. Neonatal outcome of pregnancies complicated by hypertensive disorders between 34 and 37 weeks of gestation: a 7 year retrospective analysis of a national registry. Am J Obstet Gynecol 2011; 205(6): 540.e1-7.
[] [PMID: 21907954]
Barbosa IR, Silva WB, Cerqueira GS, Novo NF, Almeida FA, Novo JL. Maternal and fetal outcome in women with hypertensive disorders of pregnancy: the impact of prenatal care. Ther Adv Cardiovasc Dis 2015; 9(4): 140-6.
[] [PMID: 26220808]
Hauth JC, Ewell MG, Levine RJ, et al. Pregnancy outcomes in healthy nulliparas who developed hypertension. Obstet Gynecol 2000; 95(1): 24-8.
[PMID: 10636496]

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2020
Page: [71 - 78]
Pages: 8
DOI: 10.2174/1573396315666191017100030

Article Metrics

PDF: 16