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Chronic hypertension diagnosed before or during pregnancy and its effects on pregnancy outcomes

Journal of Human Hypertension (2024)Cite this article

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Abstract

Chronic hypertension (CH) during pregnancy, identified before or within the first 20 weeks, presents varying risks depending on the timing of diagnosis. This real-world study was conducted from January 2018 to June 2023 and included singleton pregnancies with CH to compare pre-pregnancy CH (Group 1) and newly diagnosed CH (Group 2). There were 565 women in the final analysis, with 307 in Group 1 with pre-pregnancy CH and 258 in Group 2 with new-onset CH. Those in Group 1 more frequently had pre-gestational diabetes and a history of hypertensive disorders in pregnancy, whereas Group 2 had a higher incidence of excessive gestational weight gain. Notably, 56.2% of Group 2 patients did not receive antihypertensive treatment before 20 weeks, while the proportion was 36.2% in Group 1, resulting in a significant difference in baseline blood pressure. The study revealed higher incidences of preterm preeclampsia (44.2% vs. 34.9%) and placental abruption (5.4% vs. 2.0%) in Group 2 compared to Group 1. After adjustment, logistic regression indicated that Group 2 had a 1.8-fold higher risk of preterm preeclampsia than Group 1. These findings suggest that pregnant women newly diagnosed with CH in the first 20 weeks face increased adverse outcomes compared to those diagnosed before pregnancy. Intense monitoring and earlier intervention may help manage women with new-onset CH.

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Fig. 1: Flowchart summarizing inclusion in the study.

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Data availability

The data is available from the first author [QW Nie], upon reasonable request.

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Acknowledgements

I would particularly like to acknowledge my colleagues for their wonderful collaboration and support.

Funding

This work was supported by grants from the Guangdong Basic and Applied Basic Research Fund (Guangdong-Shenzhen Joint Fund) No.2021B1515120070.

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Author notes

  1. These authors contributed equally: Qingwen Nie, Weizhang Liang.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology; Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology; Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine; The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510150, China

    Qingwen Nie, Weizhang Liang, Yuan Xue, Lijie Pan & Fang He

  2. Department of Obstetrics, Songgang People’s Hospital, Bao’an District, Shenzhen City, Shenzhen, Guangdong, 518105, China

    Mindi Jiang

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  1. Qingwen Nie
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Contributions

Put forward the original idea and design the protocol: QW Nie, F He. Extract clinical data: Qw Nie, Y Xue, Lj Pan, Md Jiang. Data analysis and interpretation: Qw Nie, Wz Liang, F He. Manuscript writing: Qw Nie, Weizhang Liang. Revise and polish the content: F He, Wz Liang.

Corresponding author

Correspondence to Fang He.

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Competing interests

The authors declared no competing interests.

Ethical approval

The Institutional Ethics Committee of the Third Affiliated Hospital of Guangzhou Medical University approved the study protocol. According to national legislation and institutional guidelines, additional written informed consent from participants was waived for the retrospective nature of the study.

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Nie, Q., Liang, W., Xue, Y. et al. Chronic hypertension diagnosed before or during pregnancy and its effects on pregnancy outcomes. J Hum Hypertens (2024). https://doi.org/10.1038/s41371-024-00944-z

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