Hypertensive disorders in pregnancy – Trends over eight years: A population-based cohort study

Dagmar Wertaschnigg, Roshan J. Selvaratnam, Daniel L. Rolnik, Mary-Ann Davey, Shirin Anil, Ben W.J. Mol, Maya Reddy, Fabricio da Silva Costa

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Abstract

Objective: To describe the incidence and trends of hypertensive disorders of pregnancy and adverse pregnancy outcomes in recent years in Victoria, Australia. Design: Retrospective population-based cohort study, 2010 to 2017. Setting: State of Victoria, Australia. Participants: Population-based cohort study. Main outcome measures: Incidence of hypertensive disorders and its subtypes over time. Composite of major adverse maternal and perinatal outcome. Results: The incidence of hypertensive disorders (n = 36,406/614,524 pregnancies with 624,193 births) and all its subtypes has been stable, (n = 4,192/73,235 = 5.7% in 2010 to 4,601/78,576 = 5.9% in 2017). Compared to no hypertension, hypertensive disorders were associated with medically-initiated birth (aOR 4.70 [4.56, 4.84]), caesarean section (aOR 1.46 [1.43, 1.50]), placental abruption (aOR 1.94 [1.69, 2.22]), maternal intensive care or high-dependency unit admission (aOR 6.80 [6.45, 7.17]), composite of major adverse maternal outcome (aOR 3.87 [3.70, 4.04]), and composite of major adverse perinatal outcome (aOR 1.63 [1.56, 1.70]). The worst maternal and perinatal outcomes were among women with superimposed and early preterm preeclampsia. Conclusion: The incidence of all hypertensive disorders in pregnancy has remained stable over time. Early-onset preeclampsia and superimposed preeclampsia were most strongly associated with adverse pregnancy outcomes.

Original languageEnglish
Pages (from-to)60-65
Number of pages6
JournalPregnancy Hypertension
Volume28
DOIs
Publication statusPublished - Jun 2022

Keywords

  • Hypertension in pregnancy
  • Maternal and perinatal morbidity
  • Population cohort study
  • Preeclampsia
  • Pregnancy outcomes

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