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Hypertensive disorders of pregnancy and risks of adverse pregnancy outcomes: a retrospective cohort study of 2368 patients

Journal of Human Hypertension volume 35, pages 65–73 (2021)Cite this article

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Abstract

Hypertensive disorders of pregnancy (HDP) comprise a group of hypertension-related diseases and represent the most common medical disorders in pregnancy. The aim of this study was to investigate the risks of adverse pregnancy outcomes in patients with different types of HDP, including gestational hypertension, chronic hypertension, preeclampsia (PE, early or late onset), PE superimposed on chronic hypertension (superimposed PE), eclampsia, and HELLP syndrome. Data from a multicenter retrospective patient cohort in China were analyzed. Seventeen adverse maternal or perinatal outcomes were evaluated. Logistic regression was used to estimate the risk of adverse outcomes for each HDP subgroups, using the gestational hypertension group as the reference. The final analysis included 2368 patients with HDP. Of these, 39.9% of patients reported at least one adverse pregnancy outcome. Patients with early onset PE had the highest risk for having both adverse maternal and perinatal outcomes (OR = 7.28, 95% CI: 2.68, 19.79). The risk of perinatal death significantly increased in HELLP syndrome, superimposed PE, and early onset PE, (OR = 13.81, 6.32, and 4.84, respectively, p < 0.05) groups. This study highlights that among patients with HDP, those with early onset PE had the highest risk for having both adverse maternal and perinatal outcomes, and patients with HELLP syndrome had the highest risk for perinatal death.

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Fig. 1: Flowchart for included patients and study group assignment.
Fig. 2: Risk of adverse outcomes by HDP and outcome types.

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Funding

This work was supported by the National Key Research and Development Program of China (2016YFC1000206); the Science & Technology Project of Hunan Province (2017SK2151 and 2017SK1033); the National Science and Technology Pillar Program of China During the Twelfth Five-Year Plan Period (2014BAI 05B05); and the China Postdoctoral Science Foundation (2018M633000).

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Authors and Affiliations

  1. Department of Obstetrics, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha, 410008, China

    Xun Li, Weishe Zhang, Jingrui Huang, Qiaozhen Peng, Xinxiu Lin, Jiejie Zhang, Liangqun Xie, Yingming Xie, Yuanqiu Li, Jiefeng Luo, Weifang Duan, Jingfei Chen & Si Duan

  2. Hunan Engineering Research Center of Early Life Development and Disease Prevention, 87 Xiangya Road, Changsha, 410008, China

    Xun Li, Weishe Zhang, Jingrui Huang, Qiaozhen Peng, Xinxiu Lin, Jiejie Zhang, Liangqun Xie, Yingming Xie, Yuanqiu Li, Jiefeng Luo, Weifang Duan, Jingfei Chen & Si Duan

  3. Department of Obstetrics and Gynecology, Renji Hospital of Shanghai Jiaotong University School of Medicine, 145 Shandong Zhonglu, Shanghai, 20001, China

    Jianhua Lin

  4. Department of Obstetrics, Jiangxi Maternal and Child Health Hospital, 318 BayiDadao, Nanchang, 330006, China

    Huai Liu

  5. Department of Obstetrics, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China

    Zujing Yang

  6. Department of Obstetrics and Gynecology, Shanghai Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233, China

    Yincheng Teng

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  1. Xun Li
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Correspondence to Weishe Zhang or Jianhua Lin.

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The authors declare that they have no conflict of interest.

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The study protocol was reviewed and approved by the Medical Ethics Committee of the Xiangya Hospital, Center South University (reference number: 20170527). The requirement for written informed consent was waived by the Ethics Committee.

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Li, X., Zhang, W., Lin, J. et al. Hypertensive disorders of pregnancy and risks of adverse pregnancy outcomes: a retrospective cohort study of 2368 patients. J Hum Hypertens 35, 65–73 (2021). https://doi.org/10.1038/s41371-020-0312-x

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