Preeclampsia and Pregnancy outcome in Pregnant Women with Gestational Hypertension at Chonburi Hospital
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Abstract
Objectives: To determine the incidence of preeclampsia (PE) and pregnancy outcome in women diagnosed with gestational hypertension (GH) at Chonburi Hospital.
Materials and Methods: This combined retrospective-prospective cohort study collected the data of pregnant women diagnosed GH between January 2019 and April 2025. Pregnant women with chronic hypertension, abortion, or multifetal gestation were excluded. The data predicting progression from GH to PE were analyzed by logistic regression analysis.
Results: 238 pregnancies with GH were enrolled and followed until delivery. 12 of these (5.0%) lost to follow-up or delivery at other hospitals. 58 pregnant women (25.7%, 95% confidence interval (CI) 20.10, 31.88%) developed preeclampsia, and 38 of these cases (16.8%, 95% CI 8.39, 17.41%) were classified as having severe features. Logistic regression reveals that the patient diagnosed with GH before 34 weeks had a higher risk of developing PE (adjusted odds ratio (OR) 3.30, 95% CI 1.65, 6.61). Additionally, women with diastolic blood pressure ≥ 100 mmHg at diagnosis also had a higher risk of PE progression (adjusted OR 3.16, 95% CI 1.58, 6.34). The pregnant women with PE progression had higher rate of cesarean section (relative risk (RR) 1.69, 95% CI 1.44,1.98), early preterm birth (RR 8.69, 95% CI 1.80, 41.86), late preterm birth (RR 5.07, 95% CI 2.66, 9.65) and low birth weight (RR 4.34, 95% CI 2.37, 7.97).
Conclusion: PE progression occurred for a quarter number in GH pregnant women. The risks of PE progression are early gestational age of GH diagnosis and high diastolic blood pressure at diagnosis. Adverse pregnancy outcomes in preeclampsia women are preterm delivery and high cesarean section rate.
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References
Cunningham FG, Leveno KJ, Dashe JS, Hoffman BL, Spong CY, Casey BM. Williams Obstetrics, 26th ed. New York, NY: McGraw Hill: 2022.
Mathew R, Devanesan BP, Srijana, Sreedevi NS. Prevalence of hypertensive disorders of pregnancy, associated factors and pregnancy complications in a primigravida population. Gynecol Obstet Clin Med 2023:3:119-23.
Urquia ML, Glazier RH, Gagnon AJ, Mortensen LH, Nybo Andersen AM, Janevic T, et al. Disparities in pre-eclampsia and eclampsia among immigrant women giving birth in six industrialised countries. Int J Gynecol Obstet 2014:121:1492-500.
Liabsuetrakul T, Thida. Geographical distribution of hypertensive disorders in pregnancy and their adverse maternal and perinatal outcomes in Thailand. Int J Pregnancy Child Birth 2017;2:42-3.
The Royal Thai College of Obstetricians and Gynaecologists. Clinical practice guidelines of the Royal Thai College of Obstetricians and Gynaecologists: 3rd ed. Bangkok: P.A. Living; 2022.
Gestational hypertension and preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol 2020:135:e237-e60.
Seely EW, Ecker J. Chronic hypertension in pregnancy. Circulation 2014:129:1254-61.
Buchbinder A, Sibai BM, Caritis S, MacPherson C, Hauth J, Lindheimer MD, et al. Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. Am J Obstet Gynecol 2002:186:66-71.
Yemane A, Teka H, Ahmed S, Temesgen H, Langen E. Gestational hypertension and progression towards preeclampsia in Northern Ethiopia: prospective cohort study. BMC Pregnancy Childbirth 2021:21:261.
Saudan P, Brown MA, Buddle ML, Jones M. Does gestational hypertension become pre-eclampsia? Int J Gynecol Obstet 1998;105:1177-84.
Chen K-H, Seow K-M, Chen L-R. Progression of gestational hypertension to pre-eclampsia: A cohort study of 20,103 pregnancies. Pregnancy Hypertens 2017:10:230-7.
Barton JR, O’Brien JM, Bergauer NK, Jacques DL, Sibai BM. Mild gestational hypertension remote from term: Progression and outcome. Am J Obstet Gynecol 2001:184:979-83.
ACOG Committee Opinion No. 743: Low-dose aspirin use during pregnancy. Obstet Gynecol 2018:132:e44-e52.
Melamed N, Ray JG, Hladunewich M, Cox B, Kingdom JC. Gestational hypertension and preeclampsia: are they the same disease? J Obstet Gynaecol Can 2014:36:642-7.
Redman CW, Staff AC. Preeclampsia, biomarkers, syncytiotrophoblast stress, and placental capacity. Am J Obstet Gynecol 2015:213(4 Suppl):S9.e1, S9-11.
Bullarbo M, Rylander R. Diastolic blood pressure increase is a risk indicator for pre-eclampsia. Arch Gynecol Obstet 2015:291:819-23.
Nuttall FQ. Body mass index: Obesity, BMI, and health: A critical review. Nutr Today 2015:50:117-28.
Badon SE, Dublin S, Nance N, Hedderson MM, Neugebauer R, Easterling T, et al. Gestational weight gain and adverse pregnancy outcomes by pre-pregnancy BMI category in women with chronic hypertension: A cohort study. Pregnancy Hypertens 2021:23:27-33.
Garovic VD, Dechend R, Easterling T, Karumanchi SA, McMurtry Baird S, Magee LA, et al. Hypertension in pregnancy: Diagnosis, blood pressure goals, and pharmacotherapy: A scientific statement from the American Heart Association. Hypertension 2022:79:e21-e41.
