Comparison of Pregnancy Outcome Between Normotensive and Hypertensive Women with Primary Glomerulonephritis

Abstract

To examine the effect of pre-existing hypertension en pregnancy outcome, the clinical courses of 105 pregnancies undertaken by 76 wemen (55 normotensive, 21 hypertensive) with a renal biopsy diagnosis of primary glomerulonephritis have been compared. Total foetal loss was similar for both groups (18% Vs 16%) as was perinatal mortality (6% Vs 7%). Prematurity rates of hypertensive and normotensive groups were also similar (24% Vs 15%) but 25% of infants of mothers in the hypertensive group were small for gestational age compared with only 4% in the normotensive group (p<0.05). Blood pressure in excess of 90 mmHg was recorded in 47% of pregnancies in the hypertensive group despite continuation of the patients' prepregnancy anti-hypertensive therapy. This compared with a 23% incidence recorded in the normotensive group. Early hypertension was significantly more common in previously hypertensive patients' pregnancies (28%) than the normotensive group (10%) (p<0.05). Pre-existing hypertension was not a major determinant of foetal outcome in women with primary glomerulonephritis in this series although the incidence of small for gestational age infants and of early pregnancy hypertension was significantly higher if hypertension predated pregnancy Thus, at least in the absence of other risk factors, pre-existing hypertension need not be a contra-indication to pregnancy.