N M Rankhethoa1, J Moodley, M Adhikari, E Gouws. 1. Department of Paediatrics and Child Health and MRC Biostatistics, Faculty of Medicine, University of Natal, Durban.
Abstract
BACKGROUND: Perinatal mortality rates (PMR) associated with hypertension are known to be high but there have been isolated reports that primigravidae who develop hypertension late in pregnancy have a better PMR than normotensive gravid women. OBJECTIVE: To verify this report and compare the perinatal outcome in differing categories of hypertensive disorders of pregnancy. DESIGN: Maternal and neonatal data were recorded for all hypertensive patients admitted to King Edward VIII Hospital over a six month period from January to June 1995. In addition, similar data from normotensive women matched for age, parity and gestational age were also recorded. The latter formed the control group. RESULTS: Three hundred and thirty seven women were entered into the study. Group A consisted of 189 patients with hypertension, while group B consisted of 148 normotensive pregnant women. There were no significant differences between the groups in relation to maternal age and parity. More women in the hypertensive group had Caesarean sections than in the control group (study group 115 versus control 35: p = 0.001). The perinatal outcome (SBs + NNDs) was significantly greater in the control group than in the hypertensive group (p = 0.031). More importantly, the number of perinatal deaths in the aproteinuric group was significantly different from the control group (aproteinuric group = 2; control group = 26, p = 0.007). Furthermore, the hypertensive group had greater foetal weights than the control groups (controls 1.65 kg versus 2.3 kg hypertensives: p = 0.0001). CONCLUSION: This study shows that babies born to hypertensive mothers have a significantly greater birthweight than a control group of normotensive women. Further, although there are no statistically significant differences in perinatal outcome between moderate and severe categories of hypertension and control patients, there were significantly fewer perinatal deaths in women with aproteinuric hypertension.
BACKGROUND: Perinatal mortality rates (PMR) associated with hypertension are known to be high but there have been isolated reports that primigravidae who develop hypertension late in pregnancy have a better PMR than normotensive gravid women. OBJECTIVE: To verify this report and compare the perinatal outcome in differing categories of hypertensive disorders of pregnancy. DESIGN: Maternal and neonatal data were recorded for all hypertensivepatients admitted to King Edward VIII Hospital over a six month period from January to June 1995. In addition, similar data from normotensive women matched for age, parity and gestational age were also recorded. The latter formed the control group. RESULTS: Three hundred and thirty seven women were entered into the study. Group A consisted of 189 patients with hypertension, while group B consisted of 148 normotensive pregnant women. There were no significant differences between the groups in relation to maternal age and parity. More women in the hypertensive group had Caesarean sections than in the control group (study group 115 versus control 35: p = 0.001). The perinatal outcome (SBs + NNDs) was significantly greater in the control group than in the hypertensive group (p = 0.031). More importantly, the number of perinatal deaths in the aproteinuric group was significantly different from the control group (aproteinuric group = 2; control group = 26, p = 0.007). Furthermore, the hypertensive group had greater foetal weights than the control groups (controls 1.65 kg versus 2.3 kg hypertensives: p = 0.0001). CONCLUSION: This study shows that babies born to hypertensive mothers have a significantly greater birthweight than a control group of normotensive women. Further, although there are no statistically significant differences in perinatal outcome between moderate and severe categories of hypertension and control patients, there were significantly fewer perinatal deaths in women with aproteinuric hypertension.
Authors: Esme V Menezes; Mohammad Yawar Yakoob; Tanya Soomro; Rachel A Haws; Gary L Darmstadt; Zulfiqar A Bhutta Journal: BMC Pregnancy Childbirth Date: 2009-05-07 Impact factor: 3.007