Andrew E Czeizel1, Ferenc Bánhidy. 1. Foundation for the Community Control of Hereditary Diseases and Second Department of Obstetrics and Gynecology, Semmelweis University, School of Medicine, Budapest, Hungary. czeizel@interware.hu
Abstract
PURPOSE OF REVIEW: Chronic hypertension is frequent in pregnant women as well. The objective of this review is to evaluate the maternal characteristics, pregnancy complications and birth outcomes including congenital abnormalities of pregnant women with chronic hypertension by reviewing the results of published studies and mainly the data of the population-based data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities. A second aim of the review is to examine the efficacy of antihypertensive drug treatments in the reduction of pregnancy-associated risks in women with chronic hypertension. RECENT FINDINGS: Pregnant women with treated chronic hypertension had a higher risk - beyond the well known pre-eclampsia and low birthweight newborns - of threatened abortion and preterm delivery, placental disorders and gestational diabetes. In addition a higher risk of hypospadias in one and of esophageal atresia/stenosis in another study was found in the children of pregnant women with chronic hypertension. These latter findings are signals which need confirmation or rejection in other studies. SUMMARY: The present antihypertensive treatments do not neutralize the harm of severe chronic hypertension in pregnant women and in their offspring, thus it is necessary to introduce more effective drug combinations for the treatment of pregnant women with severe chronic hypertension.
PURPOSE OF REVIEW: Chronic hypertension is frequent in pregnant women as well. The objective of this review is to evaluate the maternal characteristics, pregnancy complications and birth outcomes including congenital abnormalities of pregnant women with chronic hypertension by reviewing the results of published studies and mainly the data of the population-based data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities. A second aim of the review is to examine the efficacy of antihypertensive drug treatments in the reduction of pregnancy-associated risks in women with chronic hypertension. RECENT FINDINGS: Pregnant women with treated chronic hypertension had a higher risk - beyond the well known pre-eclampsia and low birthweight newborns - of threatened abortion and preterm delivery, placental disorders and gestational diabetes. In addition a higher risk of hypospadias in one and of esophageal atresia/stenosis in another study was found in the children of pregnant women with chronic hypertension. These latter findings are signals which need confirmation or rejection in other studies. SUMMARY: The present antihypertensive treatments do not neutralize the harm of severe chronic hypertension in pregnant women and in their offspring, thus it is necessary to introduce more effective drug combinations for the treatment of pregnant women with severe chronic hypertension.