THE PROGNOSIS OF PREGNANCY IN WOMEN WITH CHRONIC HYPERTENSION

OBJECTIVE: Our purpose was to assess pregnancy outcomes in women with chronic hypertension from a population with a perinatal mortality of 12 in 1000. STUDY DESIGN: A longitudinal cohort study was performed between 1987 and 1991 in Montreal, Quebec, Canada. RESULTS: A total of 337 pregnancies in 298 women with chronic hypertension were followed up. The following outcomes were statistically more frequent in the hypertensive women than in the general population (p < 0.01): perinatal mortality (45/1000 vs 12/1000), preeclampsia (21.2% vs 2.3%), premature delivery (34.4% vs 15.0%), small-for-gestational-age newborns (15.5% vs 6.3%), primary cesarean sections (29.6% vs 14.2%), and gestational diabetes (33.1% vs 12.0%). Preeclampsia was associated with prematurity, small-for-gestational-age newborns, cesarean section, and neonatal complications. Even without superimposed preeclampsia hypertensive women had significantly higher frequencies of perinatal death (29/1000) and small-for-gestational-age newborns (10.5%) than did normotensive women (p < 0.05). CONCLUSIONS: In our population women with chronic hypertension with or without superimposed preeclampsia, have a higher incidence of perinatal death and small-for-gestational-age newborns than the general population does.