Severity of Hypertension in Pregnancy and Morbidity in the Newborn

Abstract

A prospective study on the effect of severity of hypertension in pregnancy on peri- and neonatal morbidity was conducted over a 22 month period in 1984 - 1986 at Kuoplo University Central Hospital. Five hundred and fifty-four babies without major anomalies were born alive to hypertensive and 3212 to normotenslve mothers. The Incidence of prematurity was highest (22%) among babies with maternal pre-eclampsia, Intrauterine growth retardation (IUGR) being the most frequent (42%) among preterms from this group.

All preterm babies born at 28 - 36 gestational weeks were included for analysis of peri- and neonatal morbidity, 36 “in the pre-eclampsia group, 17 in the pregnancy-induced hypertension group, 11 in the chronic hypertension group and 162” in the normotenslve control group. The respective numbers of babies “in the full-term sample were 49, 74 and 51″ in the hypertension subgroups and 220” in the normotenslve control group.

Among preterm babies maternal pre-eclampsia was associated with the highest neonatal morbidity and birth asphyxia, expressed as reduced optimality scores, and with the lowest birth weight and length. Among full-term babies those with chronic maternal hypertension had the highest neonatal morbidity and birth asphyxia even though babies with maternal pre-eclampsia had the lowest birth weight. When appropriate for gestational age (AGA) and small for gestational age (SGA) children were examined separately, the differences described between the hypertension subgroups and their controls were found mostly between AGA children. Maternal hypertension explained 22% of the between-group differences” in preterm children, mostly via Increased IUGR, and 12%” in full-term children, mostly via increased neonatal morbidity.