Neonatal outcome in infants of chronically hypertensive mothers

Aim We investigated the neonatal outcome in chronically hypertensive patients with controlled hypertension, uncontrollable hypertension, or superimposed pre-eclampsia. Material and Methods The study included 120 patients who had chronic hypertension and were divided into three groups for which the perinatal and neonatal outcomes were retrospectively compared: pre-eclampsia superimposed on chronic hypertension (SP: n=28), chronic hypertension with severe hypertension uncontrolled in spite of intravenous or multiple oral antihypertensive medications in the latter half of pregnancy (uCH: n=44), and chronic hypertension with controlled to mild hypertension with or without medication (cCH: n=48). Results Preterm birth rate incidence was significantly higher in the SP and uCH groups than in the cCH group (P<0.05 for both). The incidence rates of low birthweight, very low birthweight, and extremely low birthweight for the groups were as follows: SuCH>cCH. Admission to the neonatal intensive care unit was significantly higher in the uCH and SP groups than in the cCH group (P<0.05 for both). Conclusion Like superimposed pre-eclampsia, uncontrolled chronic severe hypertension during late pregnancy results in a poorer neonatal outcome than controlled chronic mild hypertension. We conclude that absolute blood pressure can be used as a predictor of clinical outcome in pregnant chronic hypertension patients.